Neighborhood Conditions and Gender Differences in Depressive Symptoms

Depression is a major public health challenge affecting millions of people worldwide, particularly women. Intra-individual explanations of gender differences in depression include biology (e.g., neurotransmitters, genes, hormones) and psychological factors (e.g., self-concept and esteem, mastery). Social explanations focusing on exposure to stressors (e.g., low socioeconomic status) and social role occupancy (e.g., marital and employment status) also have been considered. The recognition that environmental factors may influence mental health has given rise to studies examining the relationship between neighborhood conditions and risk for depression and psychological distress, but gender differences in neighborhood effects have yet to receive the needed research attention. This dissertation sought an understanding of: (a) gender differences in neighborhood effects on depressive symptoms, and (b) neighborhood influences on variation in depressive symptoms among women. The research is guided by the neighborhood stress process framework focusing on stressors and psychosocial resources as mediators and moderators of the relationships among neighborhood conditions and depressive symptoms. Individual-level cross-sectional data come from the Health and Retirement Survey (HRS: baseline, 2006/2008 interviews and psychosocial questionnaire supplement). The HRS is a U.S. national probability sample of adults over the age of 50. Analyses are performed within a multilevel framework and urban neighborhood data come from the 2000 U.S. Census. Among eight indicators of neighborhood disadvantage, including neighborhood socioeconomic disadvantage (NSD), and five measures of neighborhood advantage examined for gender differences in their effects on depressive symptoms, two were statistically significant but not in the expected direction. Neighborhood proportion non-family households was associated with fewer depressive symptoms among women and it had no effect among men. Neighborhood proportion married-couple households was not significantly related to depressive symptoms among women, but among men, living in a neighborhood with more married-couple households with children was associated with fewer symptoms. Overall, the impact on depressive symptoms of neighborhood characteristics do not differ for men and women. Gender differences in neighborhood effects on three individual-level stressors and three individual-level psychosocial resources also were examined. Nine interactions were statistically significant. Consistent with expectations, people who reside in neighborhoods with more vacant housing units perceived more disorder and less social cohesion in their neighborhoods, and the effects were larger for women than men. Relative to men, women's perceptions of neighborhood social cohesion and social support are more sensitive to neighborhood economic conditions. In general, with a few notable exceptions, neighborhood effects on stressors and psychosocial resources do not vary by gender. In analyses that only included women, NSD was positive and significantly associated with depressive symptoms and neighborhood proportion adults aged 65 and older was negative and significantly associated with symptoms. Perceived neighborhood social cohesion fully mediated the effect of NSD- and partially mediated the effect of neighborhood proportion older adults- on depressive symptoms. The effect on depressive symptoms of neighborhood disadvantage did not vary significantly by levels of stressors and psychosocial resources except for three significant cross-level interactions. Living in a neighborhood with more vacant housing units was associated with more depressive symptoms, and the effect was greater among women who perceived high levels of disorder in the neighborhood than those who perceived less disorder. Also as hypothesized, NSD had the largest positive effect on depressive symptoms among women with less social support than women with more support. However, mastery did not function as a stress-buffer. The effect on depressive symptoms of neighborhood advantage varied significantly by psychosocial factors. Living in a neighborhood with higher proportions of older adults was associated with fewer depressive symptoms more so for women who report low levels of perceived neighborhood physical disorder than women who report average levels of disorder. Also consistent with expectations, higher neighborhood proportion of affluent households and owner-occupied housing units were associated with fewer depressive symptoms, and the effects were larger for women with high levels of mastery than women with low mastery. However, these neighborhood characteristics were less beneficial to the mental health of women with high than low levels of social support. The findings from this dissertation largely indicate that relationships among components of the neighborhood stress process model do not differ by gender or by levels of stressors and psychosocial resources. However, the significant results that emerged make a valuable contribution to the research literature by identifying urban neighborhood conditions that are consequential to the mental health of middle-aged and older adults and that should be the target of interventions