Effect of neighborhood walkability and crime on the mental health of women living in low-income neighborhoods

Cities throughout the country are making changes to the built environment, often with the goal of improving health. Improving a city's walkability (the extent to which the built environment is pedestrian friendly) is one way in which the built environment has been shown to affect health. However, it appears that walkability may not affect all populations similarly. The purpose of this study was to determine the influence of two walkability metrics on the mental health symptoms of women living in low-income urban neighborhoods, both before and after accounting for individual and neighborhood factors. A cross-sectional, retrospective design was used. The sample of 1800 low-income women was drawn from Welfare, Children and Families: a Three-City Study (a study of low-income women from three U.S. cities). Using multi-level modeling and geographic information systems, the study sought to determine the effect of distance to public transportation and residential density on mental health symptoms. Mental health symptoms were measured using the Brief Symptom Inventory 18, which measures depression, anxiety and somatization. No significant relationship was found between these walkability metrics and mental health symptoms. Instead, neighborhood problems that affect crime and safety impacted mental health symptoms. As cities make changes to the built environment with the hope of affecting residents' health, public health nurses need to be aware that changing walkability characteristics in a neighborhood may not affect the mental health of residents of high crime, low-income neighborhoods. Without first addressing neighborhood crime, efforts to improve mental health in low-income neighborhoods may fail.