Older adults who live in poor and violent urban neighborhoods are at greater risk for depression, according to a new study.
The study, published in the journal Health & Place, showed that older adults who lived in neighborhoods with more homicide and a higher poverty rate experienced more depressive symptoms.
In fact, neighborhood homicide rates accounted for almost a third of the effect of neighborhood poverty on older adult depression, according to researchers from the University of California Davis, the University of Minnesota, Columbia University and the University of Sydney.
“Given the shift towards an aging population and the growing rates of depression among older adults, understanding the factors that contribute to depression is critical,” said Spruha Joshi, a doctoral student in epidemiology at the University of Minnesota School of Public Health and first author on the paper.
Neighborhoods in which older adults live are an important factor influencing depression and overall mental health, she said.
“We wanted to investigate the total effect poverty has on older adult depression, but also look at particular characteristics that might explain that relationship,” said Dr. Magdalena Cerdá, an associate professor in the University of California Davis Health Department of Emergency Medicine and senior author.
“Specifically, what is it about poor neighborhoods that make people depressed? This study really highlights the role violence plays in affecting mental health.”
While previous studies revealed a link between poverty and depression, few have focused exclusively on older adults, the researchers noted. In addition, previous efforts had not addressed the many conditions in poor neighborhoods that could contribute to older adult depression.
“Older adults tend to be less mobile and more dependent on the amenities, services and sources of social support in the neighborhoods where they live,” Joshi said.
For the study, the researchers used data from the New York City Neighborhood and Mental Health in the Elderly Study II (NYCNAMES II), a three-year study of elderly residents in the nation’s biggest city. Depression was measured using the nine-question Patient Health Questionnaire.
The researchers looked at several neighborhood factors that might contribute to depression, such as high homicide rates, poor perception of safety, pedestrian and bicyclist injuries, green space, social cohesion and walkability.
The study sample was 61 percent female and 47 percent non-Hispanic white. In addition, 60 percent of respondents had incomes below $40,000, the researchers noted.
While many factors were examined, violence was the only neighborhood characteristic that substantially contributed to depression in older adults in impoverished, urban communities, according to the study’s findings.
“We found that about 30 percent of the relationship between neighborhood poverty and depression was explained by the higher homicide rate,” Cerdá said.
The researchers hope their findings could help shape policy to improve quality of life for older adults in urban neighborhoods.
“Violence in the pathway between poverty and depression is a critical finding,” Joshi said. “Now we can look at neighborhoods that are not only poor but also have high levels of violence and possibly provide support for older adults in the area.”
The study highlights the key role that violence can play in shaping the mental health of local residents, Cerdá added. By investing in violence prevention in high-poverty neighborhoods, it may be possible to reduce violence and improve the mental health of vulnerable populations, she said.
More work will need to be done to figure out the relationship between neighborhood conditions and depression for older adults in impoverished neighborhoods, the researchers said.
“There are still many pathways through which poor neighborhoods can shape mental health that we don’t yet understand,” Joshi said. “Identifying these pathways will be critical if we want to identify suitable ways to promote mental health in local residents.”