title: The Neighbourhood Built Environment and Trajectories of Depression Symptom Episodes in Adults: A Latent Class Growth Analysis.
abstract: OBJECTIVE
  To investigate the effect of the neighbourhood built environment on trajectories of depression symptom episodes in adults from the general Canadian population.
  
  
  METHODS
  We used 10 years of data collection (2000/01-2010/11) from the Canadian National Population Health Study (n = 7114). Episodes of depression symptoms were identified using the Composite International Diagnostic Interview Short-Form. We assessed the presence of local parks, healthy food stores, fast food restaurants, health services and cultural services using geospatial data. We used latent class growth modelling to identify different trajectories of depression symptom episodes in the sample and tested for the effect of neighbourhood variables on the trajectories over time.
  
  
  RESULTS
  We uncovered three distinct trajectories of depression symptom episodes: low prevalence (76.2% of the sample), moderate prevalence (19.2%) and high prevalence of depression symptom episodes (2.8%). The presence of any neighbourhood service (healthy food store, fast-food restaurant, health service, except for cultural service) was significantly associated with a lower probability of a depression symptom episode for those following a trajectory of low prevalence of depression symptom episodes. The presence of a local park was also a significant protective factor in trajectory groups with both low and moderate prevalence of depression symptom episodes. Neighbourhood characteristics did not significantly affect the trajectory of high prevalence of depression symptom episodes.
  
  
  CONCLUSIONS
  For individuals following a trajectory of low and moderate prevalence of depression symptom episodes, the neighbourhood built environment was associated with a shift in the trajectory of depression symptom episodes. Future intervention studies are recommended to make policy recommendations.
authors.affiliation: Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Gariepy
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
authors.forename: Brett D
authors.initials: BD
authors.lastname: Thombs
authors.affiliation: Department of Social and Preventative Medicine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Yan
authors.initials: Y
authors.lastname: Kestens
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.affiliation: Department of Social and Preventative Medicine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Blair
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000191:economics / Q000453:epidemiology* / Q000235:genetics; D004777:Environment; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068316:Parks, Recreational / Q000706:statistics & numerical data; D015995:Prevalence; D012008:Recurrence; D012111:Residence Characteristics; D012147:Restaurants / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D063189:Symptom Assessment; D055815:Young Adult