title: Disentangling the relative influence of schools and neighborhoods on adolescents' risk for depressive symptoms.
abstract: OBJECTIVE
  Although schools and neighborhoods influence health, little is known about their relative importance, or the influence of one context after the influence of the other has been taken into account. We simultaneously examined the influence of each setting on depression among adolescents.
  
  
  METHODS
  Analyzing data from wave 1 (1994-1995) of the National Longitudinal Study of Adolescent Health, we used cross-classified multilevel modeling to examine between-level variation and individual-, school-, and neighborhood-level predictors of adolescent depressive symptoms. Also, we compared the results of our cross-classified multilevel models (CCMMs) with those of a multilevel model wherein either school or neighborhood was excluded.
  
  
  RESULTS
  In CCMMs, the school-level random effect was significant and more than 3 times the neighborhood-level random effect, even after individual-level characteristics had been taken into account. Individual-level indicators (e.g., race/ethnicity, socioeconomic status) were associated with depressive symptoms, but there was no association with either school- or neighborhood-level fixed effects. The between-level variance in depressive symptoms was driven largely by schools as opposed to neighborhoods.
  
  
  CONCLUSIONS
  Schools appear to be more salient than neighborhoods in explaining variation in depressive symptoms. Future work incorporating cross-classified multilevel modeling is needed to understand the relative effects of schools and neighborhoods.
authors.affiliation: Erin C. Dunn is with the Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA. Carly E. Milliren is with the Clinical Research Center, Boston Children's Hospital, Boston. Clare R. Evans and S. V. Subramanian are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston. Tracy K. Richmond is with the Department of Medicine, Division of Adolescent Medicine, Boston Children's Hospital, Boston.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Dunn
authors.forename: Carly E
authors.initials: CE
authors.lastname: Milliren
authors.forename: Clare R
authors.initials: CR
authors.lastname: Evans
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
authors.forename: Tracy K
authors.initials: TK
authors.lastname: Richmond
mesh_terms: D000293:Adolescent; D000367:Age Factors; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012574:Schools / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors