Neighborhood socioeconomic conditions and depression: a systematic review and meta-analysis

Abstract

Purpose: The evidence linking neighborhood socioeconomic conditions (NSEC) with depression is mixed. We performed a systematic review of this literature, including a rigorous quality assessment that was used to explore if methodological or contextual factors explained heterogeneity across studies.

Methods: A systematic literature search in three databases identified longitudinal studies among adolescents and adults living in high-income countries. Two independent reviewers screened studies for inclusion and performed data abstraction. We conducted a formal quality assessment and investigated sources of study heterogeneity.

Results: Our database search identified 3711 articles, 84 of which were determined to be potentially relevant, and 14 articles were included in this review. About half of the studies found a significant association between NSEC and depression, and pooled estimates suggest poorer socioeconomic conditions were associated with higher odds of depression (OR = 1.14, 95% CI 1.01, 1.28). Study results varied by follow-up time. Among studies with less than 5 years of follow-up, there was a significant association between NSEC and depression (OR = 1.28, 95% CI 1.13, 1.44), although pooling of study results may not be warranted due to heterogeneity across studies. Among studies with at least 5 years of follow-up, which were homogeneous, there was no association (OR = 1.00, 95% CI 0.95, 1.06) between NSEC and depression.

Conclusions: We found inconsistent evidence in support of a longitudinal association between NSEC and depression, and heterogeneity according to the length of follow-up time might partly explain the mixed evidence observed in the literature on NSEC and depression.

Keywords: Depression; Depressive symptoms; Neighborhood environment; Socioeconomic deprivation; Systematic review.