Neighborhoods and Depression: Examining the Role of Social Cohesion

Introduction: Significant health disparities and inequities exist amongst communities of color and systematically marginalized groups of people. Building upon social disorganization theory, this study examines the impact of “place” on individual mental health as a system/structure that perpetuates disparities. Globally depression is one of the leading causes of disability. A large body of research has been conducted, with most focusing on individual-level characteristics as risk factors associated with depression. However, a small but growing body of work is beginning to focus on characteristics of communities/neighborhoods related to risk for depression. The majority of this work has focused on the structural characteristics of communities, such as concentrated poverty and violence, with less attention to the mechanisms through which community characteristics may relate to mental health outcomes. In this study, we explore the mediating effects of perceptions of neighborhood social cohesion as we advance our understanding of how concentrated disadvantage and violent crime at the neighborhood level is associated with individual depressive symptomology within a sample of African American and Latino caregivers.

Methods: Participants included 603 caregivers (87% female) within 30 census tracts in high-burden neighborhoods of Chicago. Neighborhoods were selected via stratified random sampling from eligible urban neighborhoods. Eligibility for census tracts included a predominately minority population, 20-45% of households below poverty level, and a high tract crime rate. Based on these criteria, participants were 53% African American and 45% were Hispanic/Latino, and 50% of the sample had a total family income below $14,999. Participants completed measures on neighborhood social cohesion and symptoms of depression. Census and city crime data were also used to measure rates of concentrated disadvantage and violent crime.

Results: Twenty-nine percent of adults, across neighborhoods, reported risk for clinical levels of depression. Multilevel mediation analyses were used to examine if neighborhood concentrated disadvantage and levels of violent crime (level 2) were associated with individual levels of depressive symptomatology (level 1) via individual perceptions of social cohesion (level 1). Results indicated that concentrated disadvantage was associated with higher rates of depressive symptomatology, via lower levels of social cohesion (B = .27, p < .011, [95% Confidence Interval: .10, .43]. Additionally, violent crime was associated with higher rates of depressive symptomatology, via lower levels of social cohesion (B = .03, p < .01, [95% Confidence Interval: .01, .05].

Conclusions: These results indicate that social cohesion is an important mechanism in understanding the relation between neighborhood structural characteristics and depressive symptomatology. These findings have important implications for prevention efforts. Rigorous research centering caregivers of color and framed as an issue of health equity can inform the development of prevention interventions that strengthen families and communities most impacted by health disparities and inequities.