THE ASSOCIATION OF MULTIPLE NEIGHBORHOOD PERCEPTIONS WITH DEPRESSION AMONG A HIGHLY IMPOVERISHED URBAN SAMPLE

There have been multiple studies in the last decade linking mental health to neighborhood factors (Mair, Diez Roux, & Galea, 2008; Truong & Ma, 2006). Much of this research focuses on the association between neighborhood factors and depression symptoms (Galea, Ahern, Rudenstine, Wallace, & Vlahov, 2005; Latkin & Curry, 2003; Mair, et al., 2008). While numerous aspects of the neighborhood have been linked to individual depression, general neighborhood disadvantage is the most commonly studied (Mair, et al., 2008). However there is a wealth of research demonstrating the relation between neighborhood social processes and depression as well. For instance, lack of safety and high levels and fear of crime (Cutrona, et al., 2005; Kruger, Reischl, & Gee, 2007; Zule, et al., 2008), social and physical disorder (Galea, et al., 2005; Latkin, German, Hua, & Curry, 2009; Aneshensel & Sucoff, 1996; Ross & Mirowsky, 2001), and feelings of lack of control and powerlessness (Fitzpatrick, Piko, Wright, & LaGory, 2005; Ross & Mirowsky, 2009) in one’s neighborhood have all been examined in relation to depression. Neighborhood social factors are measured in multiple ways. Many studies measure neighborhood social factors objectively either through census data or utilizing objective ratings of neighborhoods by outside observers. Another common approach is to measure individuals own perceptions of their surrounding social environment. Both perceptions of one's social environment and objective ratings of neighborhood social factors have been shown to be at least moderately correlated (Perkins & Taylor, 1996). Research has shown that objective neighborhood factors to be mediated by individual perceptions of neighborhood (Ross & Jang, 2000). This suggests perceptions are critical to increasing our understanding of the neighborhood depression link. Thus, in this study we focus on perceptions of social factors, in that, it is the perception of these neighborhood conditions that are likely a proximal cause to an individual's psychological distress (Kim & Ross, 2009; Ross & Jang, 2000). Of all the neighborhood social factors studied, perceptions of neighborhood social disorder have been most consistently linked to depression. Assessment of neighborhood social disorder refers to observable signs in a neighborhood that social controls are weak (Geis & Ross, 1998; Skogan, 1990). These neighborhood dynamics are generally characterized by conditions such as high amounts of vandalism, trash, drug sales, and other crime and incivilities. Studies examining perceptions of social control and fear of crime/lack of safety have been found to be significantly associated with depressive symptoms as well, though not as consistently as social disorder. Fear of crime has been shown to be related to later depression in general populations (Ross & Mirowsky, 2001; Stafford, Chandola, & Marmot, 2007). A similar construct of perceptions of safety has also been examined specifically among substance users and found to be associated with depression. Similarly, perceptions of institutional control have been shown to be important in predicting depression. However, other researchers have found no association between social control and depression (Steptoe & Feldman, 2001). As perception of these neighborhood conditions have been consistently linked to psychological distress (Kim & Ross, 2009; Ross & Jang, 2000), perceptions of one's neighborhood are critical to further our understanding of neighborhood influence on depression. Further, some studies have found that objective neighborhood indicators lose their significance when perceptions of the neighborhood are included in the model suggesting that they are mediated by individual perceptions (Ross & Jang, 2000). One salient pathway in which many of these social factors may be linked to depression is through stress. Highly impoverished and disadvantaged areas are likely to be a source of many stressors. Neighborhood stressors, when present, tend to be chronic, and chronic stressors present in the environment may be particularly deleterious for individual mental health (Cohen, et al., 1982; Turner & Lloyd, 2003; Turner, Wheaton, & Lloyd, 1995). The presence of physical or social disorder such as vacant housing, teenagers on the street corners, and selling drugs may help to create a general sense the neighborhood is unsafe and not well controlled, thus creating chronic stress and in turn increasing the propensity for depression (Hill, Ross, & Angel, 2005). In addition to the cumulative impact of neighborhood stressors, prior exposure to certain stressors such as gangs and drug users may lead to perception that one is vulnerable to future stressors such as being a victim of crime. An additional mechanism that increases stress is lack of perceived control over the neighborhood stressors (Mirowsky & Ross, 1990). Feeling that neither they nor authorities are able to prevent or respond adequately to crime in the neighborhood may reduce perceived control and create a continual strain and worry. While these neighborhood social factors have been studied in the general population, they have been studied to a much lesser extent among highly impoverished populations, who experience high rates of crime and have a history of drug use. Both drug users (Kessler et al., 2003) and individuals living in poverty (Ross & Mirowsky, 1989) tend to have higher of depressive symptoms than the general population, suggesting the need to understand influences of depression specifically among this population. Furthermore, research suggests that substance users may have different perceptions of their neighborhood (Latkin, German, Hua, & Curry, 2009) and may also differ in how these perceptions influence their psychological wellbeing. Previous research has also shown that the influence of neighborhood factors on mental health may differ depending on the level of poverty in the neighborhood (Ross & Jang, 2000). In order to better understand the relationship of neighborhood perceptions and depression, multiple neighborhood measures should be assessed and compared against one another in the same model. Despite this growing body of research examining the neighborhood and depression link, the specific type of neighborhood characteristics that have the greatest influential on depressive symptoms remains poorly understood. One reason for this lack of understanding is that many studies examining neighborhoods and mental health measure neighborhood environment as a global measure such as neighborhood disadvantage or neighborhood socioeconomic status. While other studies have examined specific factors such as social disorder or fear of crime, they are not as commonly assessed in conjunction with other neighborhood social factors. This study sought to add to this growing body of literature by examining multiple neighborhood factors simultaneously and how each one may affect the presence of depression, in a sample of highly impoverished individuals residing in urban neighborhoods with high rates of crime. We hypothesized that, when assessed individually, negative perceptions of neighborhood would be associated with higher odds of depression. We further hypothesized that when multiple neighborhood constructs are combined in the same model, certain neighborhood perceptions would be independently associated and hence retain a significant association with depression. Specifically, we examined the level of social disorder, perceived efficacy of institutions or oneself to control social disorder, and the perception of future neighborhood threats, specifically crime, and how these 4 factors relate to depressive symptoms.