Neighbourhood environment and the incidence of depressive symptoms among middle-aged African Americans.
OBJECTIVE
To investigate the association between attributes of subject location and incidence of clinically relevant levels of depressive symptoms (CRLDS), and to investigate whether an association remained after adjusting for individual-level factors using data from the population-based African American Health Study.


METHODS
An 11-item depression scale (Center for Epidemiologic Studies Depression scale) was obtained at baseline and 3 years later through in-home evaluations. Census tract and block group deprivation indices were obtained from the 2000 census. The external appearance of the block where the subject lived was rated during sample enumeration, and the interior and exterior of the subject's dwelling were observed during the initial in-home interview.


RESULTS
Of 998 subjects at baseline, 21.1% had CRLDS. Although 12.7% of the 672 people without CRLDS at baseline developed them by the 3-year follow-up, univariate and propensity-adjusted analyses revealed no association between the subject's location and the incidence of CRLDS. Sensitivity analyses confirmed the robustness of the findings.


CONCLUSIONS
Despite other studies showing independent effects of neighbourhood characteristics on the prevalence of CRLDS, attributes of subject location are not independent contributors to the incidence of CRLDS in middle-aged urban African Americans.
Schootman
Mario
M
Department of Medicine and Pediatrics, Washington University School of Medicine, St Louis, MO, USA. mschootm@im.wustl.edu
Andresen
Elena M
EM
Wolinsky
Fredric D
FD
Malmstrom
Theodore K
TK
Miller
J Philip
JP
Miller
Douglas K
DK
D001741:Black or African American / Q000523:psychology*; D000368:Aged; D003863:Depression / Q000453:epidemiology*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D011204:Poverty Areas; D015995:Prevalence; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D018881:Suburban Health; D014504:Urban Health