Neighborhood disadvantage in context: The influence of Urbanicity on the association between neighborhood disadvantage and adolescent emotional disorders

Kara Rudolph, Elizabeth A. Stuart, Thomas A. Glass, Kathleen R. Merikangas

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: Inconsistent evidence of a relationship between neighborhood disadvantage and adolescent mental health may be, in part, attributable to heterogeneity based on urban or rural residence. Using the largest nationally representative survey of US adolescent mental health available, we estimated the association between neighborhood disadvantage and adolescent emotional disorders and the extent to which urbanicity modified this association. Methods: The National Comorbidity Survey Replication Adolescent Supplement (NCS-A) sampled adolescents aged 13-17 years (N = 10,123). Households were geocoded to Census tracts. Using a propensity score approach that addresses bias from non-random selection of individuals into neighborhoods, logistic regression models were used to estimate the relative odds of having a DSM-IV emotional disorder (any past-year anxiety disorder, major depressive disorder or dysthymia) comparing similar adolescents living in disadvantaged versus non-disadvantaged neighborhoods in urban center, urban fringe, and non-urban areas. Results: The association between neighborhood disadvantage and emotional disorder was more than twice as large for adolescents living in urban centers versus non-urban areas. In urban centers, living in a disadvantaged neighborhood was associated with 59 % (95 % confidence interval 25-103) increased adjusted odds of emotional disorder. Conclusions: Urbanicity modifies the relationship between neighborhood disadvantage and emotional disorder in adolescents. This effect modification may explain why evidence of a relationship between neighborhood disadvantage and adolescent mental health has been inconsistent. Recognizing the joint influence of neighborhood socioeconomic context and urbanicity may improve specificity in identifying relevant neighborhood processes.

Original languageEnglish (US)
Pages (from-to)467-475
Number of pages9
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume49
Issue number3
DOIs
StatePublished - Mar 1 2014
Externally publishedYes

Fingerprint

adolescent
Mental Health
mental health
Vulnerable Populations
Logistic Models
Geographic Mapping
Propensity Score
Major Depressive Disorder
comorbidity
Censuses
Anxiety Disorders
Diagnostic and Statistical Manual of Mental Disorders
supplement
evidence
Comorbidity
census
Joints
confidence
logistics
Odds Ratio

Keywords

  • Adolescent
  • Mental health
  • Neighborhood
  • Propensity score
  • Psychiatric epidemiology
  • Survey

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Epidemiology
  • Health(social science)
  • Social Psychology

Cite this

Neighborhood disadvantage in context : The influence of Urbanicity on the association between neighborhood disadvantage and adolescent emotional disorders. / Rudolph, Kara; Stuart, Elizabeth A.; Glass, Thomas A.; Merikangas, Kathleen R.

In: Social Psychiatry and Psychiatric Epidemiology, Vol. 49, No. 3, 01.03.2014, p. 467-475.

Research output: Contribution to journalArticle

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