Urban neighborhood, depressive symptoms, and older adults: Stress and psychosocial resources

Background: Existing research shows that residents of socioeconomically disadvantaged neighborhoods have a relatively high risk of some types of mental illness. This study investigated whether this pattern is present for depressive symptoms among persons in late middle age to extreme old age, and if so why. Investigated factors include: stressors (neighborhood physical disorder and financial strain) and psychosocial resources (mastery, social support, and religious service attendance). Age cohort differences were examined. Methods: This was a secondary analysis of data from the 2006 and 2008 Health and Retirement Study . The analytic sample included 8,623 adults aged 52 to 104, residing in 3216 urban neighborhoods (census tracts). Neighborhood socioeconomic disadvantage (NSD) was operationalized with a principal component of Census tract indicators (education, poverty, public assistance, and unemployment). Depressive symptoms were measured by an 8-item version of the Center for Epidemiologic Studies Depression Scale. Hierarchical linear regression estimated multilevel models. Results: NSD was positively associated with depressive symptoms, net of individual-level demographic characteristics used to control for selection. Exposure to stressors partially explained the association; while psychosocial resources suppressed it. A significant, curvilinear cross-level interaction with age was found: NSD is positively associated with symptoms among those under 64, but has little effect among persons 65 to 74 year, and is negative at older ages. Conclusion: The mental health disparity for depressive symptoms in disadvantaged neighborhoods is partially due to greater exposure to stressors and fewer resources to counteract this exposure. The counter-intuitive inverse association among the oldest adults warrants further investigation.