Association of the Neighborhood Built Environment With Incident and Prevalent Depression in the Rural South

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Anderson, Christopher E. ; Broyles, Stephanie T. ; Wallace, Maeve E. ; Bazzano, Lydia A. ; Gustat, Jeanette
• Description:
  Introduction
  
  A neighborhood’s built environment is associated with physical activity among its residents, and physical activity is associated with depression. Our study aimed to determine whether the built environment was associated with depression among residents of the rural South and whether observed associations were mediated by physical activity.
  
  Methods
  
  We selected 2,000 participants from the Bogalusa Heart Study who had a valid residential address, self-reported physical activity (minutes/week), and a complete Center for Epidemiologic Study–Depression (CES-D) scale assessment from 1 or more study visits between 1998 and 2013. We assessed the built environment with the Rural Active Living Assessment street segment audit tool and developed built environment scores. The association between built environment scores and depression (CES-D ≥16) in geographic buffers of various radii were evaluated by using modified Poisson regression, and mediation by physical activity was evaluated with mixed-effects models.
  
  Results
  
  Depression was observed in 37% of study participants at the first study visit. One-point higher physical security and aesthetic scores for the street segment of residence were associated with 1.07 times higher (95% CI, 1.02–1.11) and 0.96 times lower (95% CI, 0.92–1.00) baseline depression prevalence. One-point higher destination scores (ie, more commercial and civic facilities) in radius buffers of 0.25 miles or more were associated with 1.06 times (95% CI, 1.00–1.13) the risk of depression during follow-up. Neighborhood poverty (defined as percentage of residents with incomes below the federal poverty level and dichotomized at 28.3%) modified cross-sectional and longitudinal associations. Associations were not mediated by physical activity.
  
  Conclusion
  
  The built environment was associated with prevalence and risk of depression, and associations were stronger in high-poverty neighborhoods. Built environment improvements to promote physical activity should take neighborhood context into consideration to minimize negative side effects on mental health in high-poverty communities.
  
  
• Subjects:
  Original Research
• Source:
  Prev Chronic Dis. 2021; 18
• ISSN:
  1545-1151
• Pubmed ID:
  34237245
• Pubmed Central ID:
  PMC8269752
• Document Type:
  Journal Article
• Funding:
  R01 HL121230/HL/NHLBI NIH HHSUnited States/ ; R21 AG057983/AG/NIA NIH HHSUnited States/ ; R01 DK091718/DK/NIDDK NIH HHSUnited States/ ; K12 HD043451/HD/NICHD NIH HHSUnited States/ ; R01 AG041200/AG/NIA NIH HHSUnited States/ ; P20 GM109036/GM/NIGMS NIH HHSUnited States/
• Volume:
  18
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:1debd9e71fb3b85e1f5b54c02bf8aa2179501bf78365983ac3ad076eb1a344540b7e94566950bf7d9e33a662b5e16bfdfe465810f1a37ac7637e2acaa4fa0dee
• Download URL:
  https://stacks.cdc.gov/view/cdc/108363/cdc_108363_DS1.pdf
• File Type:
  [PDF - 566.02 KB ]