Does changing neighborhoods affect mental health?

Does changing neighborhoods affect mental health?

Studies examining the causes of mental health problems mainly focus on individual factors measured during the individual’s life (McLaughlin et al., 2011). However, a preliminary conclusion from a literature review on neighborhood characteristics and mental health problems points to limited effects of individual-level interventions in improving mental health (Thuong and Ma, 2006). As an alternative, Thuong and Ma (2006) suggest that future research investigates the effect of neighborhood-level interventions.

In general, studies on neighborhood characteristics and residents mental health indicate that the contextual factors of the neighborhood, such as low- income level, high unemployment and crime rate, are associated with an increase in the risk of mental health problems (see e.g.,Beckner et al., 2000, Leventhal  and Brooks-Gunn, 2003, Klebanov et al., 1994). Still, the results from previous literature are mixed and the literature often lacks good data to define neighborhoods and to follow the individuals’ health status and moving patterns over longer periods. 

In this paper, we examine the relationship between mental health of residents and their neighborhood characteristics using administrative register data for the full Danish population from 1995 through 2014. In particular, we investigate individuals’ use of mental health services and prescription of medicine in different residential areas. We use the panel data and show the relationship between people moving to a certain residential area and detected changes in their mental health up to 5 years before and after the move. In order to overcome the limitations of selection bias and to determine the causal impact of moving to certain residential areas on mental health care use we exploit the randomization of municipal social housing offer in the two largest cities of Denmark.

While the previous studies mainly measure mental health utilizing small samples of the population, the administrative register data are particularly useful for studying the relationship between mental health and neighborhood characteristics. As all Danish psychiatric hospitals are public, all admissions and discharges are recorded in the administrative registers. Furthermore, all treatment at the psychiatric hospitals is free, so that no attrition rate in data exists and even characteristics of the most severe mental health problems are registered. Besides information on use of mental health services and prescription of medicine from 1995 through 2014 the Danish administrative data contains information about socioeconomic characteristics, demographics, housing, and moving patterns, which makes it possible to follow individuals over time. Using information on individual residential addresses, we construct neighborhoods based on both geographically defined quadrants and the characteristics of the nearest 200 neighbors. All the characteristics of the neighbors are known on individual level.

The preliminary results show that people moving to a deprived area suffer from more mental problems after the move compared with people moving to other areas (private rental areas and other public housing areas). Thus neighborhood-based interventions might have a significant positive impact on mental health for some of the most disadvantages groups of the population.