Abstract
The ways in which a neighborhood environment may affect depression and depressive symptoms have not been thoroughly explored. This study used longitudinal data from 5475 adults in the Multi-Ethnic Study of Atherosclerosis to investigate associations of time-varying depressive symptoms between 2000 and 2012 (measured using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D)) with survey-based measures of neighborhood safety and social cohesion (both individual-level perceptions and neighborhood-level aggregates) and densities of social engagement destinations. Linear mixed models were used to examine associations of baseline cross-sectional associations and cumulative exposures with changes over time in CES-D. Econometric fixed effects models were utilized to investigate associations of within-person changes in neighborhood exposures with within-person changes in CES-D. Adjusting for relevant covariates, higher safety and social cohesion and greater density of social engagement destinations were associated with lower CES-D at baseline. Greater cumulative exposure to these features was not associated with progression of CES-D over 10 years. Within-person increases in safety and in social cohesion were associated with decreases in CES-D, although associations with cohesion were not statistically significant. Social elements of neighborhoods should be considered by community planners and public health practitioners to achieve optimal mental health.