Opening the black box of neighborhood socioeconomic status and mental health: the role of neighborhood social characteristics as contextual mechanisms

Background: Previous studies have linked living in socioeconomically deprived neighborhoods to mental health problems. However, only a few studies have investigated the potential mechanisms explaining this association and most of the studies focus only on the association between deprived neighborhoods and negative indicators of mental health such as symptoms of depression or anxiety.

Aims: This paper addresses this gap by investigating whether social characteristics of neighborhoods (social interaction, trust, safety, civic engagement, and attachment) mediates the association between neighborhood socioeconomic status and mental health.

Method: We combined Danish register data on individual and neighborhood sociodemographic characteristics with survey data from the North Denmark Region Health Survey 2017 to measure neighborhood social characteristics and mental health. Mental health was measured with the instrument (SF-12) to cover both positive, negative, hedonic, and eudemonic aspects of mental health.
The sample consisted of 14,969 individuals nested into 1,047 neighborhoods created using an automated redistricting algorithm. We fitted multilevel mediation models following a structural equation framework and used a Monte Carlo simulation method to estimate the indirect effects.

Results: Neighborhood socioeconomic status was positively associated with higher mental health status. Trust between neighbors acted as a significant and independent mediator accounting for 34% of the association between neighborhood socioeconomic status and mental health.

Conclusion: These results indicate that higher mental health associated with living in more affluent neighborhoods can be partly explained by higher levels of neighborhood trust. Improvements in trust between residents in neighborhoods could mitigate socio-geographical inequalities in mental health.