title: The Effects of the Urban Built Environment on Mental Health: A Cohort Study in a Large Northern Italian City.
abstract: Mental health (MH) has a relevant burden on the health of populations. Common MH disorders (anxiety and non-psychotic depression) are well associated to socioeconomic individual and neighborhood characteristics, but little is known about the influence of urban structure. We analyzed among a Turin (Northwest Italy) urban population the association at area level of different urban structure characteristics (density, accessibility by public transport, accessibility to services, green and public spaces) and consumption of antidepressants. Estimates were adjusted by individual socio-demographic variables (education, housing tenure, employment) and contextual social environment (SE) variables (social and physical disorder, crime rates). Data was extracted from the Turin Longitudinal Study (TLS)-a census-based cohort study following up prospectively the mortality and morbidity of the population. As expected, individual characteristics show the strongest association with antidepressant drug consumption, while among built environment (BE) indicators accessibility by public transport and urban density only are associated to MH, being slightly protective factors. Results from this study, in agreement with previous literature, suggest that BE has a stronger effect on MH for people who spend more time in the neighborhood. Therefore, this research suggests that good accessibility to public transport, as well as a dense urban structure (versus sprawl), could contribute to reduced risk of depression, especially for women and elderly, by increasing opportunities to move around and have an active social life.
authors.affiliation: Environmental Heritage and Urban Redevelopment Unit, SiTI-Higher Institute on Territorial Systems for Innovation, via Boggio 61, 10138 Torino, Italy. giulia.melis@siti.polito.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Melis
authors.affiliation: ASL Torino 5, Local Public Health Agency, piazza S. Pellico 1, 10023 Chieri, Italy. gelormino.elena@aslto5.piemonte.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Gelormino
authors.affiliation: Environmental Heritage and Urban Redevelopment Unit, SiTI-Higher Institute on Territorial Systems for Innovation, via Boggio 61, 10138 Torino, Italy. giulia.marra@polito.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Marra
authors.affiliation: SEPI Grugliasco, Epidemiology Service for ASL Torino 3, Local Public Health Agency, via Sabaudia 164, 10095 Grugliasco, Italy. elisa.ferracin@epi.piemonte.it.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ferracin
authors.affiliation: SEPI Grugliasco, Epidemiology Service for ASL Torino 3, Local Public Health Agency, via Sabaudia 164, 10095 Grugliasco, Italy. giuseppe.costa@epi.piemonte.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costa
mesh_terms: D000328:Adult; D019352:Censuses; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D004779:Environment Design; D005006:Ethnicity; D005260:Female; D006798:Housing; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009017:Morbidity; D012111:Residence Characteristics; D012931:Social Environment; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D044465:White People; D055815:Young Adult
keywords: Turin Longitudinal Study; accessibility; built environment; health; inequalities; public transport; social environment; urban density; urban structure