Neighborhood effects on the depression trajectories of rural adolescent girls

Background: As in urban settings, social determinants of mental health, such as neighborhood socioeconomic disadvantage and social disorganization, may adversely impact young women living in rural communities. Based on theories of chronic stress and strain, we hypothesized that the developmental trajectories of depression of rural girls would show higher initial levels and later peak ages of distress in disadvantaged or disorganized neighborhoods. Objective: To examine the contribution of the neighborhood context to the development of depression in rural adolescent girls. Methods: We used data from a 5-wave panel study of 2,565 adolescent girls. The sample was 52% white and 38% black, with an average age of 13 years at baseline. The analysis employed multilevel growth curve models. Results: The trajectory showed a steady linear increase in depression between ages 11 and 18. The highest initial levels of depression were among girls living in socioeconomically disadvantaged neighborhoods. An additional increase in initial levels of depression due to social disorganization approached significance. There were no differences in the peak ages of depression due to the neighborhood factors, which indicates that the early differences in depression persisted at all ages in the trajectory. Conclusions: Our results suggest that girls' mental health varies according to neighborhood borders within rural communities, and that early interventions are needed in disadvantaged areas to combat depression during adolescence.