All posts by gergobaranyi

Crime and violence in the neighbourhood affects our mental health

Our review published in Social Science and Medicine synthetized available evidence on the relationship between living in neighbourhoods affected by crime and violence, and residents’ mental health problems. The findings clearly showed that people residing in unsafe areas are more likely to report mental health problems, including depression and psychological distress, but we also found some indication for elevated levels of anxiety and psychotic symptoms.

The places where we live, work and age are important in shaping our health and wellbeing. There have been a number of recent studies that have considered whether and how physical and social features of these places may influence mental health. Characteristics of places including economic and social disadvantage, lack of social cohesion between neighbours or restricted access to green space are seem to be important in affecting the mental health of local people. Another aspect of place that might matter is the level of local crime and violence but we don’t have a clear picture of the importance of these processes because the research in this area has not be systematically reviewed and assessed.

Crime events tend not to be random but instead concentrate in certain neighbourhoods. Research in criminology suggests that disadvantaged and low-income areas are particularly affected by crime and violence, especially when there is a lack of social cohesion in the area and it is therefore difficult for people living in this area to collaborate together and make the changes that they want to see in their community (Figure 1). We also know that within most neighbourhoods there are particular places   where crime is more frequent (e.g. areas with poor quality street lighting).

Figure 1: Neighbourhood crime and mental health

Once crime occurred, people directly affected as being victim or witnessing crime, are at risk of developing mental health problems, such as depression and post-traumatic stress disorder. However, and importantly, residents of higher crime areas, even without direct experiences of crime, may be affected through increased fear and chronic stress, and through other responses such as lower engagement in physical and social activities in their communities. These can all contribute to mental health problems in high crime areas.

In order to get a better understanding of what the international evidence tells us about the connections between local crime and mental health, we screened over 10,000 research articles from 11 major databases and identified 63 relevant studies published in over 30 countries and across a wide range of disciplines (e.g. psychology, public health, economics and criminology). We then used these findings to create a comparable metric across studies which were then quantitatively summarized across the 63 studies – an approach known as ‘meta-analysis’. We found that people living in local areas with higher levels of crime and violence suffered more often from depression and psychological distress. A variety of additional analyses confirmed these results, and findings remained robust when we considered differences across sample and methodological characteristics, such as age of participants, study design or methodological quality. We found comparably fewer studies focussing on anxiety and psychosis, but they also pointed towards increased mental health problems in unsafe neighbourhoods.

This systematic review and meta-analysis is the first in the literature exploring the relationship between local crime and mental health. Although the impact of neighbourhood crime on mental health is comparably smaller than the impact of well-established risk factors, such as being unemployed or experiencing maltreatment, we have to consider that large parts of the population are living in areas seriously affected by crime. Urban centres, especially in low- and middle-income countries, experienced a recent surge in crime and violence, which likely affects residents’ well-being.

Neighbourhood crime and violence is a significant social, economic, legal and global health concern. The results of our review are important because they suggest that reducing crime levels and increasing the feeling of safety among residents can benefit population mental health. Policymakers might consider targeting the physical (e.g. reducing alcohol availability, area rehabilitation) and social (e.g. supporting social cohesion and participation) determinants of crime by complex neighbourhood interventions, as these have the potential to reduce crime levels in a sustainable way. Healthcare planners should be mindful about the increased mental health needs of communities affected by high crime. Scaling up mental health services by providing access to treatment for those in need and considering preventive measures, such as developing skills and coping strategies, may tackle the mental health burden of disadvantaged neighbourhoods.

You can find the paper here:

Baranyi G, Di Marco MH, Russ TC, Dibben C, Pearce J. The impact of neighbourhood crime on mental health: A systematic review and meta-analysis. Social Science & Medicine 2021; 282: 114106. https://www.sciencedirect.com/science/article/abs/pii/S027795362100438X

Neighbourhood problems lead to depression, but effects vary across countries

Neighbourhood characteristics are linked to mental health in older age, but the magnitude of effects might differ across countries. Using data from 16 different countries, our paper in the American Journal of Epidemiology indicated that country-level social, political, economic and environmental characteristics may explain differences in how neighbourhood affects mental health.

Depression, local area and macro-level context

Depression is a common mental disorder with substantial disability and economic burden worldwide. More than 10% of adults aged 50 years and older present depressive symptoms with an even greater proportion of the population suffering in older age groups. Older adults spend more time in their neighbourhood, so that social and physical features of the residential area become increasingly important for them.

Signs of neighbourhood disorder, such as crime, vandalism and exposure to rubbish, are thought to indicate problems in the residential environment, by elevating the level of stress and fear among residents. On the other hand, positive aspects of neighbourhoods such as social cohesion – which is often characterised as a sense of community, help and support among neighbours – have the potential to buffer the effects of stress and contribute to healthy ageing. Both neighbourhood disorder and social cohesion has been linked to mental health problems.

Neighbourhoods are situated within macro-level environments capturing larger geographic areas such as local authorities, counties or even countries (Figure 1). Policies, as well as social, economic and environmental characteristics of macro environments can affect citizens’ life and health, and also shape the physical and social characteristics of local communities, where people live and age. It is important, as both local and macro-level environments are modifiable, presenting opportunities for improving population mental health and contributing to healthy ageing.

Figure 1: Local and macro-level determinants of depression

Neighbourhoods influence mental health among older adults

We investigated the associations between neighbourhood disorder, lack of social cohesion and depression among adults aged 50 and over. Longitudinal information on perceived neighbourhood characteristics and depressive symptoms across 16 high-income countries were utilised, including 32000 older adults. Results showed that living in an area with significant neighbourhood disorder increased the chance of developing depression (Figure 2), and so did lack of social cohesion (Figure 3). If people were already in retirement, effects became stronger.

Figure 2: Neighbourhood disorder impacting depression across 16 high-income countries. Odds Ratios <1.0 indicate decreased odds of depression by exposure to neighbourhood disorder; Odds Ratios >1.0 express increased odds. Small black diamonds are country-specific estimates, larger empty diamonds are pooled effects across group of countries. Abbreviations: ELSA, English Longitudinal Study of Ageing; HRS, Health and Retirement Study; SHARE, Survey of Health, Ageing and Retirement in Europe.

Neighbourhood effects differ across countries

As the magnitude of the associations varied across the 16 included countries, we further explored country-level differences.

Figure 3: Lack of social cohesion impacting depression across 16 high-income countries. Odds Ratios <1.0 indicate decreased odds of depression by lack of social cohesion; Odds Ratios >1.0 express increased odds. Small black diamonds are country-specific estimates, larger empty diamonds are pooled effects across group of countries. Abbreviations: ELSA, English Longitudinal Study of Ageing; HRS, Health and Retirement Study; SHARE, Survey of Health, Ageing and Retirement in Europe.

Amongst other, we found that in countries with higher population density, lack of social cohesion was more detrimental for mental health. Particularly in the oldest age groups, where limited mobility is more likely present, neighbours can be an important source of social and emotional support. In countries where people live closer to each other, not having proper social ties to neighbours can lead to social isolation and higher risk of developing mental health problems.

Also, in countries with higher pension spending, the adverse effect of neighbourhood disorder on depression was buffered for individuals already in retirement. It is plausible that by providing material resources, more generous welfare states equip older people to deal with stressors arising from less safe and deteriorated residential neighbourhoods.

Macro-level context and policy recommendations

Understanding how larger context can influence mental health inequalities across neighbourhoods has the potential to inform policy, and provide more tailored recommendations. For example, tackling crime and vandalism in countries with lower pension spending would be particularly beneficial for mental health, as older people has less material resources to protect themselves from the negative effects of neighbourhood disorder. Supporting social ties and improving social capital in densely populated areas may stronger contribute to healthy ageing and lead to better mental health among older adult.

By Gergő Baranyi, School of Geosciences, University of Edinburgh