Elsevier

Public Health

Volume 129, Issue 7, July 2015, Pages 932-940
Public Health

Original Research
The longitudinal effects of neighbourhood social and material deprivation change on psychological distress in urban, community-dwelling Canadian adults

https://doi.org/10.1016/j.puhe.2015.05.011Get rights and content

Highlights

  • This is the first study to examine neighbourhood change and distress in Canada.

  • The study examines a geo-coded longitudinal cohort of urban-dwelling Canadians.

  • Most neighbourhoods did not change drastically over the six year period studied.

  • Worsening material deprivation was associated with worse distress scores.

Abstract

Objective

The purpose of this study was to assess how longitudinal changes in neighbourhood material and social deprivation affect distress outcomes in adult Canadians.

Study design

This study used a prospective cohort approach.

Methods

We paired data from 2745 urban participants of Canada's National Population Health Survey—who completed the Kessler 6-Item psychological distress screening tool at baseline and follow-up—with neighbourhood social and material deprivation data from the census-based Pampalon Deprivation Index. Data were paired using participants' postal code. We conducted multiple linear regression models, which were stratified by baseline deprivation level and controlled for key confounders.

Results

Most participants lived in neighbourhoods that did not change drastically in social or material deprivation level during the six years between baseline and follow-up. We found that a worsening of material settings was significantly associated with worsening distress scores at follow-up. This finding is discussed in the context of existing literature, and made relevant for urban health research and policy.

Introduction

Neighbourhood social, economic, and physical environments impact the mental health of their residents.1, 2 Neighbourhoods are areas of chronic exposure to both socio-economic stressors and protective social ties.3 They can therefore impact affective symptomatology.4 Several systematic literature reviews and longitudinal studies have observed an association between neighbourhood-level measures, such as neighbourhood income, social capital, and social disorder, and prospective mental health outcomes such as depressive and distress symptoms in urban-dwelling adults.1, 2, 5, 6, 7 However, a limitation of neighbourhood mental health literature is that neighbourhood social and economic exposures have mostly been measured cross-sectionally. It is therefore unclear whether changes in neighbourhood environments impact the mental health outcome of residents over time.

Certain forms of neighbourhood change can occur due to planned public health, urban planning, or political interventions, while others are naturally-occurring. For example, several studies have examined the effects of neighbourhood renewal and regeneration projects designed to improve the mental or physical health outcomes of residents, as well as the social and aesthetic qualities of living environments.8, 9, 10, 11, 12, 13, 14, 15, 16 Their results are mixed, but most report that an improvement of the social, material, and economic environments of neighbourhoods are associated with bettered outcomes of psychological well-being.

In this study we are interested in naturally-occurring, population-level neighbourhood change, given that these are the changes most likely to affect general urban populations. To our knowledge only two studies have examined the longitudinal mental health effects of unplanned, naturally-occurring material, social, and economic changes at the neighbourhood level.17, 18 One of these studies is a qualitative evaluation of the psychological impact of economic gentrification in working-class neighbourhoods of Montreal, Canada.17 The second study tested associations between fluctuations in perceived neighbourhood disorder and affective health.18 Both studies observed an association between neighbourhood change and worsening psychological well-being. When neighbourhood circumstances worsened (i.e. through an increase in disorder) or when the social networks of neighbourhoods were modified (i.e. through an influx of new residents, and a modification of social spaces), residents reported higher levels of distress.17, 18

The overall paucity of quantitative analysis on the subject of neighbourhood change and mental health is alarming in the Canadian context, given contemporary trends in neighbourhood transformation. In the past 20 years, researchers have noted that the social and economic inequalities in Canadian cities are becoming more apparent.19 It is therefore important to examine how changes in the socio-economic contexts of neighbourhoods impact the mental and physical health of Canadians. It is our intention with this study to assess the psychological effects of changes in neighbourhood social and material deprivation, by achieving the following goals: (1) describing types of neighbourhood change experienced by urban-dwelling Canadians between 2001 and 2006, and (2) comparing the psychological distress outcomes of people living in neighbourhoods that have become better or worse—materially and socially—over time.

Section snippets

Sample

Data used in this study were drawn from the 4th and 7th waves (years 2000 and 2006, respectively) of the Canadian National Population Health Survey (NPHS), a longitudinal survey of a nationally-representative sample of Canadians (which has been described elsewhere20). Ethics and study design for the NPHS study was originally approved by Statistics Canada. The sample of this study is restricted to urban21 community-dwelling, non-institutionalized adult participants (aged 18 years and above at

Descriptive statistics

At baseline (Table 1), the average age of our sample was of 53 years, 56% were women, and the majority of the sample were married, Caucasian, had a medium to high level of income adequacy, were employed, and achieved a high-school education or higher. The average distress score was of 0.67, which is comparable to the Canadian national average for women (0.67; CI 0.66–0.68) and for men (0.61; CI 0.59–0.62).32

Patterns of neighbourhood change

The distribution of neighbourhood change experienced by study participants between 2000

Discussion

This study achieved its first objective of offering a cursory description of the types of neighbourhood deprivation change experienced by a sample of urban-dwelling Canadians between 2000 and 2006. Given our classification of deprivation change, the majority of participants lived in neighbourhoods that did not change drastically in social or material deprivation level during the six years between baseline and follow-up. Nearly 40% of participants lived in neighbourhoods with constant high

Acknowledgements

Thanks are extended to Dr. Kaberi Dasgupta, Dr. Kimberley Smith, and Bonnie Au, MSc, for their help and support.

Ethical approval

None sought.

Funding

Authors AB, NS, and GG receive funding from the Canadian Institutes of Health Research (CIHR) (Operating Grant 2007-2009). AB also receives funding from the Fonds de la recherche en santé du Québec (FRSQ) (Dossier 28229) and the Quebec Inter-university Center for Social Statistics (QICSS) (Student Bursary).

Conflicts of interest

The authors declare that there is no duality of interest associated

References (44)

  • D. Kim

    Blues from the neighborhood? Neighborhood characteristics and depression

    Epidemiol Rev

    (2008)
  • R.J. Sampson et al.

    Assessing “neighborhood effects”: social processes and new directions in research

    (2002)
  • C.E. Cutrona et al.

    Neighborhood characteristics and depression: an examination of stress processes

    Curr Dir Psychol Sci

    (2006)
  • O.S. Dalgard et al.

    Urban environment and mental health. A longitudinal study

    Br J Psychiatry

    (1997)
  • P. Huxley et al.

    Urban regeneration and mental health

    Soc Psychiatry Psychiatr Epidemiol

    (2004)
  • R. Mehdipanah et al.

    The effects of an urban renewal project on health and health inequalities: a quasi-experimental study in Barcelona

    J Epidemiol Community Health

    (2014)
  • A. Rogers et al.

    More than jobs and houses: mental health, quality of life and the perceptions of locality in an area undergoing urban regeneration

    Soc Psychiatry Psychiatr Epidemiol

    (2008)
  • R. Whitley et al.

    Can urban regeneration programmes assist coping and recovery for people with mental illness? Suggestions from a qualitative case study

    Health Promot Int

    (2006)
  • A.M. Renzaho et al.

    Resident well-being, community connections, and neighbourhood perceptions, pride, and opportunities among disadvantage metropolitan and regional communities: evidence from the Neighbourhood Renewal Project

    J Community Psychol

    (2012)
  • V.F. Burns et al.

    Revisiting the role of neighbourhood change in social exclusion and inclusion of older people

    J Aging Res

    (2011)
  • M.L. Beeble et al.

    The impact of neighborhood factors on the well-being of survivors of intimate partner violence over time

    Am J Community Psychol

    (2011)
  • R.A. Walks et al.

    Ghettos in Canada's cities? Racial segregation, ethnic enclaves and poverty concentration in Canadian urban areas

    Can Geogr

    (2006)
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