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. 2021 Nov;25(11):2078-2089.
doi: 10.1080/13607863.2020.1793898. Epub 2020 Jul 21.

Neighborhood environment perceptions associate with depression levels and cardiovascular risk among middle-aged and older adults: Data from the Washington, DC cardiovascular health and needs assessment

Marcus R Andrews  1 , Joniqua Ceasar  1 , Kosuke Tamura  1 , Steven D Langerman  1 , Valerie M Mitchell  1 , Billy S Collins  1 , Yvonne Baumer  1 , Cristhian A Gutierrez Huerta  1 , Amit K Dey  2 , Martin P Playford  2 , Nehal N Mehta  2 , Tiffany M Powell-Wiley  1   3
Affiliations

Neighborhood environment perceptions associate with depression levels and cardiovascular risk among middle-aged and older adults: Data from the Washington, DC cardiovascular health and needs assessment

Marcus R Andrews et al. Aging Ment Health. 2021 Nov.

Abstract

Objectives: Little is understood about associations between neighborhood characteristics and depression, a cardiovascular disease (CVD) risk factor, in diverse populations. We examined relationships between perceived/objective neighborhood characteristics, depression, and CVD markers within the Washington, DC CV Health/Needs Assessment, an evaluation among predominantly African-American (AA) adults in resource-limited DC communities.

Method: Factor analysis of overall neighborhood environment perception (NEP) identified three NEP sub-scores:1) violence; 2) physical/social environment; 3) social cohesion (higher score = more favorable perception). Objective neighborhood characteristics were measured by geospatially-derived scores of walkability, transportation, and crime. Depression was defined by the revised Center for Epidemiologic Studies Depression Scale (CESD-R). We used linear-regression modeling to examine neighborhood measures and CESD-R associations. To investigate a subsequent connection with CVD risk, we examined relationships between CESD-R and CVD-associated cytokines in a population subset.

Results: Participants (N = 99; mean age = 59.06; 99% AA) had a mean CESD-R score = 5.8(SD = 8.88). In adjusted models, CESD-R scores decreased by 0.20 units (p = 0.01) for every overall NEP unit-increase. Perceived physical/social environment (β = -0.34, p = 0.04) and social cohesion (β = -0.82, p = 0.01) were related to CESD-R while perceived violence was not (β = -0.28, p = 0.1). Of objective neighborhood environment measures (i.e. walk, transit, bike, personal crime, and property crime scores), only property crime score was associated with depression (β = 4.99, p < 0.03). In population subset (n = 42), higher CESD-R associated with higher IL-1β (β = 21.25, p < 0.01) and IL-18 (β = 0.006, p = 0.01).

Conclusion: Favorable neighborhood perceptions are related to lower depressive symptoms in a predominantly AA cohort from Washington, DC resource-limited communities. Neighborhood perceptions appear to be strongly associated with depressive symptoms compared to objective characteristics. Increasing CESD-R scores were related to higher pro-inflammatory markers. Improving neighborhood perceptions may be beneficial to psychological well-being and CV health for urban minority residents.

Keywords: Neighborhood environment; cardiovascular disease; depression; inflammatory markers; psychosocial health.

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Conflict of interest statement

Disclosure statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Conceptual Model examining the Proposed Linkages between Neighborhood Environments, Depression, and Cardiovascular Markers.
Figure 2.
Figure 2.
More Favorable neighborhood perception factors associate with Lower CESD-R scores among participants from the Washington, DC Community Health and Needs Assessment (N = 99). *Note: Models adjusted for: Household Income, Neighborhood Deprivation Index, Body Mass Index, and ASCVD risk score (95% Confidence Interval).
See this image and copyright information in PMC

References

    1. Ahuja C, Ayers C, Hartz J, Adu-Brimpong J, Thomas S, Mitchell V, … Powell-Wiley TM (2018). Examining relationships between perceptions and objective assessments of neighborhood environment and sedentary time: Data from the Washington, D.C. cardiovascular health and needs assessment. Preventive Medicine Reports, 9, 42–48. doi: 10.1016/j.pmedr.2017.12.002 - DOI - PMC - PubMed
    1. Alesci S, Martinez PE, Kelkar S, Ilias I, Ronsaville DS, Listwak SJ, … Gold PW (2005). Major depression is associated with significant diurnal elevations in plasma interleukin-6 levels, a shift of its circadian rhythm, and loss of physiological complexity in its secretion: Clinical implications. The Journal of Clinical Endocrinology & Metabolism, 90(5), 2522–2530. doi: 10.1210/jc.2004-1667 - DOI - PubMed
    1. Andrews MR, Tamura K, Claudel SE, Xu S, Ceasar JN, Collins BS, Langerman S, Mitchell VM, Baumer Y, & Powell-Wiley TM (2020). Geospatial analysis of neighborhood deprivation index (NDI) for the United States by county. Journal of Maps, 16(1), 101–112. doi: 10.1080/17445647.2020.1750066 - DOI - PMC - PubMed
    1. Bailey EJ, Malecki KC, Engelman CD, Walsh MC, Bersch AJ, Martinez-Donate AP, … Nieto FJ (2014). Predictors of discordance between perceived and objective neighborhood data. Annals of Epidemiology, 24(3), 214–221. doi: 10.1016/j.annepidem.2013.12.007 - DOI - PMC - PubMed
    1. Bailey RK, Mokonogho J, & Kumar A (2019). Racial and ethnic differences in depression: Current perspectives. Neuropsychiatric Disease and Treatment, 15, 603–609. doi: 10.2147/NDT.S128584 - DOI - PMC - PubMed

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