Neighborhood Disadvantage Is Associated with Depressive Symptoms but Not Depression Diagnosis in Older Adults

Courtney J. Bolstad, Reagan Moak, Cynthia J. Brown, Richard E. Kennedy and David R. Buys
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Courtney J. Bolstad: Department of Psychology, Mississippi State University, Mississippi State, MS 39762, USA
Reagan Moak: Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, MS 39762, USA
Cynthia J. Brown: Division of Gerontology, Geriatrics, and Palliative Care and Integrative Center for Healthy Aging, University of Alabama Birmingham, Birmingham, AL 35294, USA
Richard E. Kennedy: Division of Gerontology, Geriatrics, and Palliative Care and Integrative Center for Healthy Aging, University of Alabama Birmingham, Birmingham, AL 35294, USA
David R. Buys: Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, MS 39762, USA

IJERPH, 2020, vol. 17, issue 16, 1-10

Abstract: Disadvantaged neighborhood environments may have low access to healthcare, perpetuating health disparities. Previous research has reported on associations between neighborhood disadvantage (ND) and depressive symptomology but not depression diagnoses, which may indicate access to healthcare. This study tested how ND relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Data from 998 community-dwelling, Black and White individuals aged 65+ included in the University of Alabama at Birmingham Study of Aging were analyzed. We obtained participants’ depressive symptomology from the Geriatric Depression Scale ( n = 100) and a verified depression diagnosis from self-report and review of medication, physician-report, and/or hospital discharge summaries ( n = 84). We assessed ND from US Census data, divided the sample into tertiles of ND and fit models with Generalized Estimating Equations covarying for various other variables (e.g., sex, race, physical performance, socioeconomic status, etc.). We found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. Therefore, older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.

Keywords: neighborhood disadvantage; depression diagnosis; depressive symptomology; healthcare access; health disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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