The Neighbourhood Built Environment and Trajectories of Depression Symptom Episodes in Adults: A Latent Class Growth Analysis

Abstract

Aim: To investigate the effect of the neighbourhood built environment on trajectories of depression symptom episodes in adults from the general Canadian population.

Research design and 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.

Fig 1. Trajectories of probability of depression symptom episodes over time in the NPHS (2000/01-2010/11).

Trajectories from a 3-class latent class growth model incorporating age, sex, marital status, education, income adequacy, childhood life events, chronic condition and family history of depression. The red line represents the trajectory with high prevalence of depression symptom episodes; the green line, moderate prevalence; the blue line, low prevalence.

Fig 2. Trajectories of prevalence of depression symptom episodes over time in the NPHS (2000/01-2010/11) with and without presence of parks in the neighbourhood during the study period.

Trajectories that include time-varying presence of parks in the growth model. The dashed lines represent trajectories when presence of park is set to “no park” across the study period. The solid lines represent trajectories when presence of park is set to “presence of park” across the study period.