Neighbourhood effects, local crime and mental health: longitudinal analyses over the life course
View/ Open
Baranyi2020.pdf (5.723Mb)
Date
03/07/2020Author
Baranyi, Gergő
Metadata
Abstract
Mental health conditions are major contributors to global disability and suffering,
with a substantial social and economic burden. Besides well-established individuallevel biopsychosocial determinants, emerging literature emphasises that social and
physical features of the residential environment are associated with mental health.
However, there is a limited understanding of how, where and for whom
neighbourhood matters for mental health, partly because of the methodological
shortcomings of existing literature. This thesis takes a longitudinal approach to
examine the links between place-based factors, in particular neighbourhood crime,
and anxiety, depression and psychosis.
A systematic review and meta-analysis on the association between local crime and
mental disorders sets the context for the thesis. Based on 50 studies meeting the
inclusion criteria, random-effects meta-analyses indicated higher risk of depression
and psychological distress in high crime areas; for anxiety and psychosis there was
only limited evidence. Associations varied by study design (longitudinal versus
cross-sectional), type of crime measurement (perceived versus objective) and between
different age groups. Importantly, the review identified research gaps, which were
the focus of the following chapters. The thesis was structured around four
longitudinal investigations, two utilizing perceived and two objective
neighbourhood measurements.
First, available evidence in the field is limited to a few countries and there is no
information on country-level heterogeneity. Data on perceived neighbourhood
conditions and depression from 16 countries were utilised across three ageing cohorts
(English Longitudinal Study of Ageing; Health and Retirement Study; Survey of
Health, Ageing and Retirement in Europe [SHARE]) capturing adults aged 50 and
over (n=32,531). Findings indicated elevated risk of depression amongst participants
living in an area with perceived neighbourhood disorder (including crime) or with
lack of social cohesion. Further analyses uncovered cross-level interactions by income inequality, population density and air pollution for social cohesion and by forest
coverage for neighbourhood disorder.
Second, neighbourhood effects might be determined by vulnerability build up over
the life course; however, no information is available on the long-term impact of
childhood stressors, a sensitive period in human development. Prospective and
retrospective data on adults aged 50 and over (n=10,328), were analysed from the
SHARE survey. In addition to a higher risk of depression when living in areas with
perceived neighbourhood nuisances (including crime), and lower in areas with good
access to neighbourhood services, childhood socioeconomic conditions modified
neighbourhood effects. Older adults who grew up in better childhood circumstances
benefited more from neighbourhood resources, but they were at higher risk of
depression when exposed to neighbourhood problems.
Third, there is a lack of understanding of different neighbourhood crime and mental
health associations across psychiatric conditions. A large data-linkage study (Scottish
Longitudinal Study [SLS]), on small area-level crime rates and prescribed
psychotropic medications was carried out (n=129,945). Findings indicated higher risk
of antidepressants and antipsychotics, but not anxiolytics medications in high crime
areas. Moreover, there was higher risk of antidepressants prescriptions among adults
aged 24-53 in 2009, antipsychotics among men aged 44-53 in 2009, and among those
in the middle of the social ladder, when living in high crime areas.
Fourth, although changing levels of neighbourhood exposure may help in
understanding the causal relationship between context and health, very few studies
have utilised repeated measurements of small area-level crime. Analysis based on the
previous study (SLS) with additional linkage for three consecutive area crime
measurements were carried out, to explore the association of changing crime rates
with self-reported mental illness and prescribed medications among residential
stayers and movers (n=112,251). Recent increase in crime exposure was associated
with mental health problems among stayers aged 16-30 (self-reported mental illness,
antidepressants), and among movers aged 31-45 (self-reported mental illness,
antipsychotic medication). After excluding individuals with pre-existing mental health conditions, findings suggested causation for the former, and health selective
migration for the latter group.
Neighbourhood crime and other contextual factors in the residential area are
significant determinants of mental health, but associations differ by childhood and
adult socioeconomic conditions, across sex and age groups, and between anxiety,
depressive and psychotic disorders. Place-based interventions aimed at reducing
crime, supporting social cohesion and allocating targeted mental health preventions
and services in the vicinity of high crime areas, may have long-term benefits for
residents’ mental health, especially for those more vulnerable. Future research should
investigate the relationship between area stressors and mental health by exploring
direct and indirect pathways, studying crime effects at different geographical levels,
and applying the life course framework.
Related items
Showing items related by title, author, creator and subject.
-
Pathways to health in a deprived population: relationships between smoking, mental health & physical health
Kemp, Kim (The University of Edinburgh, 2011-06-30)Introduction: Recently there has been increasing interest in understanding and addressing health inequalities and enhancing the well-being of the population as a whole through anticipatory care and better health care ... -
Role of oral health promotion in oral health policy : a comparative analysis of two European countries
Schou, Lone (The University of Edinburgh, 1992) -
Is mentalising ability associated with mental health difficulties in adolescents? A systematic review: understanding the construct of mentalising in adolescence and its association with mental health, a structural equation model
Battersby, Shona (The University of Edinburgh, 2018-11-30)Mentalising is an “imaginative mental activity that enables us to perceive and interpret human behaviour in terms of internal mental states (e.g. needs, desires, feelings, beliefs, goals, purposes and reasons)” (Bateman ...