Associations among neighborhood poverty, perceived neighborhood environment, and depressed mood are mediated by physical activity, perceived individual control, and loneliness. (March 2020)

• Record Type: Journal Article
• Authors: Kowitt, Sarah D.; Aiello, Allison E.; Callahan, Leigh F.; Fisher, Edwin B.; Gottfredson, Nisha C.; Jordan, Joanne M.; Muessig, Kathryn E.
• Is Part Of: Health & place. Volume 62(2020:Mar.)
• Publication Date: 2020-03
• Subjects: Depression -- Neighborhoods -- Mediation -- Loneliness -- Older adults; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2019.102278
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: Few studies have documented the pathways through which individual level variables mediate the effects of neighborhoods on health. This study used structural equation modeling to examine if neighborhood characteristics are associated with depressive symptoms, and if so, what factors mediated these relationships. Cross-sectional data came from a sample of mostly rural, older adults in North Carolina (n = 1, 558). Mediation analysis indicated that associations among neighborhood characteristics and depressive symptoms were mediated by loneliness (standardized indirect effect = −0.19, p < 0.001), physical activity (standardized indirect effect = −0.01, p = 0.003), and perceived individual control (standardized indirect effect = −0.07, p = 0.02) with loneliness emerging as the strongest mediator. Monitoring such individual mediators in formative and process evaluations may increase the precision of neighborhood-based interventions and policies. Highlights: Few neighborhood studies have conducted mediation analysis. Objective and perceived neighborhood characteristics influenced depression. Physical activity, loneliness, and perceived individual control were mediators. Loneliness emerged as the strongest mediator.