Can your neighbourhood shape your mental health?

Background

I have moved a lot over the past 15 years. I have moved houses, moved cities, moved countries, and continents. Each place I have lived has very different vibes – from the rural home I spent my formative years with vegetable gardens and chickens to the Toronto loft in the junction. It is likely that each place affected my health ways in myriad ways. Like the student flat that was filled with mold and centipedes, the fatal shooting a block from my Toronto home, the frost bite I endured when waiting for a bus during a polar vortex in Ottawa, and the shockingly poor water quality in London.

Neighbourhoods cover the full spectrum of positive and negative factures, but does your neighbourhood affect your mental health?

I think my neighbourhood can affect my mood and mental health. Weathering the pandemic in London was challenging (so many people, so little space). The slivers of parkland were slim tethers to sanity when the world was shrunk to our immediate surroundings.

I have been very interested in understanding how place can affect our mental health. I know I felt different in each of my neighbourhoods but it is hard to know what exactly in these neighbourhoods made me feel connected, supported, happy, and healthy.

Research question

Are neighbourhood factors, both subjective and objective, linked to rates of suicide thoughts and attempts?

This is a complicated question because many people live in areas with people with similar characteristics. This makes it hard to untangle if higher levels of suicidal thoughts and attemps are because of the characteristics of the individuals clustered in that neighbourhood – compositional or if it is aspects of the neighbourhoodthat lead to high rates – contextual.

For example, if we compare two areas of Stockholm (where this research was conducted) there are some very expensive neighbourhoods. Most people who can afford to live in these areas have high incomes, higher educations, and more likely to be Swedish-born. These are all individual characteristics. However, these areas tend to have better transit lines, more green spaces, and tend to be considered “nice and desirable” places to live. In contrast, there are other areas that feel “sketchy.” They may have visible signs of neighbourhood neglect or deprivation. These are also areas where rents are cheaper, so people with lower incomes tend to live in these under-resourced places.

What did we do?

We used information collected in the Stockholm Public Health Cohort, including 20,764 people across 889 neighbourhoods in Stockholm county. We looked at objective and subjective neighbourhood factors:

Objective neighbourhood factors:

• Neighbourhood deprivation

• Neighbourhood fragmentation

Subjective neighbourhood factors:

• Trust in those living in your neighbourhood (trust, reciprocity, and bonds between neighbours)

• Average trust in public and political institutions (confidence in official structures and institutions)

Outcomes - suicidality We measured suicidal thoughts and attempts, collected in the self-report questionnaire in 2002, 2006, 2010, and 2014.

What did we find?

We found that there was variation in suicidal thoughts and attempts across neighbourhoods, but that much of the the neighbourhood variation in suicidality was explained by the clustering of people with similar characteristics (compositional).

That said, higher levels of neighbourhood deprivation and lower average trust in neigbours also increased rates of suicidal thoughts and attempts.

Read more

Read the full paper in Psychological Medicine

Behind the research

This research was started by one of my brilliant MSc students – Kavya Ashok and other colleagues at UCL and the Karolinska Institutet.