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Neighborhood, family significantly impact children's mental health

Analysis of a nationally representative cohort of Swedish children indicated neighborhood deprivation was significantly associated with increased risk for anxiety disorders, mood disorders and ADHD.

“While several studies have suggested a link between neighborhood characteristics and adult mental health outcomes, fewer studies have examined potential neighborhood-level effects on psychopathology in children and adolescents. Furthermore, previous studies have been limited by small sample sizes, inadequate adjustment for confounding, or modeling that did not optimally distinguish individual and family from neighborhood-level effects,” study researcher Jan Sundquist, MD, PhD, of Lund University in Malmö, Sweden, and colleagues wrote.

Jan Sundquist

To assess associations between neighborhood deprivation, familial and individual factors and incidence of internalizing and externalizing psychiatric disorders, researchers reviewed medical records for 542,195 Swedish children born in 1992 to 1996. Study participants represented 427,954 families and 8,475 neighborhoods. The cohort was followed from 2000 to 2010.

Overall, 4.8% of study participants were diagnosed with internalizing or externalizing psychiatric disorders.

Twenty-nine percent of individual variance in internalizing disorders was due to family level, including both genetic and family environmental effects, and 5% was attributed to neighborhood level.

Regarding externalizing disorders, 43.5% of individual variance was attributed to family level and 5.5% to neighborhood level.

When adjusting for individual sociodemographic factors, high neighborhood deprivation increased risk for externalizing (OR = 1.37; 95% CI, 1.25-1.5) and internalizing psychiatric disorders (OR = 1.34; 95% CI, 1.25-1.45).

Specifically, high neighborhood deprivation increased risk for conduct disorders (OR = 2.01; 95% CI, 1.58-2.55), anxiety disorders (OR = 1.4; 95% CI, 1.29-1.52) and mood disorders (OR = 1.21; 95% CI, 1.09-1.35), according to adjusted analysis. Further, associations between risk for ADHD and neighborhood were highest in moderately deprived neighborhoods (OR = 1.31; 95% CI, 1.19-1.44).

“Although individuals who live in highly deprived neighborhoods may be strongly affected by their neighborhood environments, these findings may imply that familial factors are more important than neighborhood factors at the population level,” Sundquist and colleagues concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.