Original ResearchThe longitudinal effects of neighbourhood social and material deprivation change on psychological distress in urban, community-dwelling Canadian adults
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
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2022, Social Science and MedicineCitation Excerpt :This corroborates earlier research indicating that improvements in neighbourhood deprivation among non-movers resulted in better health and lower mortality (Boyle et al., 2004; Xiao et al., 2018) and a lower risk of mental disorders (Kivimäki et al., 2021). However, contrary to our findings for suicide, Blair et al. (2015) observed no association between distress and improved material conditions or with decreased social deprivation. Lower suicide mortality in neighbourhoods with urban vs. rural conditions and among movers from rural to urban neighbourhoods might be related to established rural risk factors for suicide such as social isolation, access to means, stigmatisation, and lower access to mental health care facilities (Hirsch and Cukrowicz, 2014).
Examining longitudinal patterns of individual neighborhood deprivation trajectories in the province of Quebec: A sequence analysis application
2021, Social Science and MedicineCitation Excerpt :We found that a majority (64%) of the participants who did not move had a stable neighborhood deprivation trajectory. This is comparable to results obtained by Blair et al. (2015), who found, in a sample representative of the Canadian population, 82% of non-movers saw no change in their neighborhood deprivation between 2000 and 2006. This suggests that dissemination area SES is relatively stable over time.
Neighborhoods, psychological distress, and the quest for causality
2020, Current Opinion in PsychologyCitation Excerpt :In many studies, associations have been observed only with some, but not all, of the neighborhood or distress measures included in the study. For example, associations have been observed with proximity to urban parks but not to forests [26]; with material but not social neighborhood deprivation [18]; or with psychological distress but not life satisfaction [24]. This weakens the overall evidence because there seems to be no good explanations why the causal associations would be observed only with the specific measures.
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