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>The effects of urban residential environments on mental well being: A multilevel analysis of neighborhood stability, middle income composition and depression in Detroit.
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The effects of urban residential environments on mental well being: A multilevel analysis of neighborhood stability, middle income composition and depression in Detroit.
Neighborhood residential stability is widely considered to be beneficial to the health of neighborhoods and the people who live in them, but may influence health differently depending on neighborhood income composition. To examine these effects in an older, predominantly low income industrial city, multilevel analysis is performed on data from the Healthy Environments Partnership, a community based participatory research project in Detroit, Michigan. Individual data from a stratified proportional sample survey of 919 persons living in 69 block group neighborhoods were linked with 2000 U.S. Census data. Major depression was measured by the CIDI, with an unadjusted prevalence of 18% in this sample.; Findings from hierarchical logistic regression indicate that the effect of neighborhood stability on depression varies by neighborhood percent middle income ({dollar}40,000 and above). Residential stability is beneficial to mental health in neighborhoods with high proportion of middle income residents, but is detrimental to mental health in neighborhoods with few middle income residents. In stable neighborhoods, the probability of major depression is three times higher when there are 20% compared to 50% middle income households in the neighborhood. However, in very unstable neighborhoods, depression is substantially higher in middle income compared to low income neighborhoods. Rates of depression are comparable in unstable middle income and stable low income neighborhoods.; Further, residential stability predicted higher depression in neighborhoods that experienced decline in proportion middle income residents 1990-2000. The racial composition of neighborhoods did not modify the relationship between neighborhood factors and health. Neither individual financial vulnerability nor social support mediated the path between neighborhoods and depression, although both exhibited strong individual effects on depression.; Findings indicate a need for further cross disciplinary research into how structural features of neighborhoods interact to affect mental health. Policies and interventions to regenerate disinvested cities should target neighborhoods based on evidence regarding neighborhood structure and mental health. Strategies to attract additional middle income residents should include efforts to prevent involuntary displacement of current residents, as well as opportunities for economic mobility. Collaboration across sectors and that equitably engages community members may contribute to reducing the burden of mental disorders in disinvested cities.
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