Does neighborhood poverty modify the association between and depressive symptomatology and allostatic load?

Background: Increased stress, due to social factors including neighborhood socioeconomic deprivation, negatively affects health. Higher allostatic load, which captures cumulative biologic stress, is associated with greater risk for several chronic conditions, including both cardiovascular disease and depression. It is unclear, however, whether the association between depressive symptomatology and allostatic load is modified by neighborhood poverty. Methods: Using data collected by the Healthy Environments Partnership, a community based participatory research partnership, multilevel regression analyses examined the moderating effects of neighborhood poverty on associations between depression and allostatic load. Neighborhood poverty was measured as the proportion of households within the neighborhood living in poverty as defined by the US Census. Depressive symptomatology was captured using the Center for Epidemiologic Studies of Depression (CES-D) scale. Results: Depressive symptomatology was associated with increased allostatic load scores (b=0.20, SE=0.09, p=0.03). Moderating effects of neighborhood poverty were suggested (b=0.02, SE=0.01, p=0.01). Among residents of high poverty (80%) neighborhoods, greater depressive symptomatology was associated with increased allostatic load scores. Implications: Neighborhood poverty modified the association between depressive symptomatology and allostatic load. Findings suggest variation in physical health when both socioeconomic stressors and mental health are considered. This interaction highlights the interconnectedness of social context, mental health, and physical health. Additional work to understand the demographic characteristics of the sample by poverty level, depressive symptomatology, and allostatic load will also be presented to better understand these associations.