A new study published in Social Psychiatry and Psychiatric Epidemiology finds that children from disadvantaged neighborhoods experience more negative mental health symptoms throughout their lives.
The research followed 2125 participants from ages 4 to 69. Poorer mental health was observed for children at age 13 that had lived in disadvantaged areas at age 4. Similarly, the authors found poorer mental health at ages 60-64 and age 69 for participants that lived in disadvantaged areas during their young adulthood. The authors write:
“Cohort members who experienced increasing area disadvantage from childhood were at increased risk of poor mental health over the life course. Population-wide interventions aiming at improving social and physical aspects of the early neighbourhood environment could reduce the socioeconomic burden of poor mental health.”
The current work set out to examine the mental health consequences of living in disadvantaged areas throughout the lifecourse. The authors used data collected from the MRC National Health Survey of Health and Development, a British investigation that followed participants from age 4 to 69.
This investigation used a self-report mental health scale (Pintner Aspects of Personality Inventory) as well as teacher ratings of behavior and emotionality at ages 13-15. At age 36, participants were evaluated by trained nurses using semi-structured interviews (a short version of the Present State Examination). At age 43, the participants responded to the Psychiatric Symptom Frequency scale (a scale derived from the Present State Examination). At ages 53, 60-64, and 69, participants responded to a self-administered General Health Questionnaire.
The authors accounted for the following confounding factors: childhood cognitive ability, individual socioeconomic position, and educational attainment.
The current work reports a significant association between living in a disadvantaged neighborhood at age 4 and measures of neuroticism at age 13-15. The authors found similar associations between living in disadvantaged neighborhoods at age 4 and scores on the General Health Questionnaire at ages 60-64 (early disadvantage was associated with poorer health). This association also existed at ages 36, 43, and 53, although much weaker than at ages 13-15 and 60-64.
The current work finds less evidence for lasting negative mental health effects from living in disadvantaged areas as an adult. There was no association between area disadvantage at 26 and negative mental health symptoms at ages 36, 43, and 53. Similarly, no link was found between area disadvantage at age 53 and mental health symptoms at ages 53, 60-64, and 69. However, there was a link between area disadvantage at age 26 and poorer mental health at ages 60-64 and 69.
Additionally, the authors found a link between individual socioeconomic position and increased sensitivity to living in a disadvantaged area. Overall, participants from “manual” labor social classes suffered increased mental health issues linked to living in disadvantaged areas when compared to participants from “non-manual” labor social classes.
The authors acknowledge several limitations to the current study. Several different measures of mental health were used throughout the data collection process. While the authors note there is no reason to believe a consistent measure would change the overall pattern, the fact remains that the changed could have altered the outcomes.
This study suffered from selective sample attrition in which participants with less social advantage and poorer mental health were more likely to leave the study before completion. The boundaries utilized by the study to judge which neighborhoods were disadvantaged were administrative ones that changed over time. The authors conclude:
“Our results are consistent with a lifelong association of area disadvantage with poor mental health, where a disadvantaged environment could increase the risk of poor mental health; and these risks could be more pronounced in participants from more disadvantaged individual socioeconomic backgrounds. Improving neighbourhood environments is a tractable, though complex, issue, and therefore measures to fund and facilitate area-based interventions, such as jobs skill training seminars or psychosocial support for vulnerable individuals, may represent a potentially impactful primary health measure for the prevention of poor population mental health.”
Research has found that transitioning into poverty is linked to behavioral issues in children. Childhood poverty has also been linked to early neurological impairment. One study from 2018 found that poverty may be driving increased distress and declining well-being in poor White Americans.
A recent study found that poverty leads to changes in the brain that may be responsible for some behavioral issues in adolescents. Similar research found that childhood poverty leaves a “neural imprint” on the brain that may persist into adulthood.
Psychotherapy is less effective for people living in poverty. Research has found that people of lower socioeconomic status often feel alienated and estranged in therapy which likely leads to decreased efficacy. Research has also found that how your pain is treated medically depends on your socioeconomic status. Race and class can also affect psychiatric diagnosis.
****
Bakolis, I., Murray, E. T., Hardy, R., Hatch, S. L., & Richards, M. (2023). Area disadvantage and mental health over the life course: A 69-year prospective birth cohort study. Social Psychiatry and Psychiatric Epidemiology. https://doi.org/10.1007/s00127-023-02427-x (Link)
