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American Journal of Epidemiology Advance Access originally published online on June 29, 2005
American Journal of Epidemiology 2005 162(3):253-260; doi:10.1093/aje/kwi185
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

Neighborhood Contextual Influences on Depressive Symptoms in the Elderly

Laura D. Kubzansky, S. V. Subramanian, Ichiro Kawachi, Martha E. Fay, Mah-J. Soobader and Lisa F. Berkman

From the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA

Reprint requests to Dr. L. Kubzansky, Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115-6096 (e-mail: lkubzans{at}hsph.harvard.edu).

To understand whether neighborhood contexts contribute to the onset or maintenance of mental health problems independently of individual characteristics requires the use of multilevel study designs and analytical strategies. This study used a multilevel analytical framework to examine the relation between neighborhood context and risk of depressive symptoms, using data from the New Haven component of the Established Populations for Epidemiologic Studies of the Elderly, a community-based sample of noninstitutionalized men and women aged 65 years or older and living in the city of New Haven, Connecticut, in 1982. Neighborhoods were characterized by census-based characteristics and also by measures of the neighborhood service environment using data abstracted from the New Haven telephone book Yellow Pages. Living in a poor neighborhood was associated with higher levels of depressive symptoms in older adults, above and beyond individual vulnerabilities. In addition, the presence of more elderly people in the neighborhood was associated with better mental health among older adults. The authors found no evidence that access to services hypothesized to promote social engagement, to provide health services, or to affect the reputation of a neighborhood explained (i.e., mediated) neighborhood variations in depressive symptoms.

aged; depression; residence characteristics

Abbreviations: CES-D, Center for Epidemiologic Studies Depression; EPESE, Established Populations for Epidemiologic Studies of the Elderly


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