The longitudinal association between living in socially fragmented neighbourhoods and psychological distress among middle aged adults in Brisbane, Australia.

OBJECTIVE

Addressing social determinants of affective disorders is increasingly recognised as a major priority in mental health. This longitudinal study aimed to examine the effect of neighbourhood social fragmentation on psychological distress among mid-to-older aged (40-65 yrs) community dwelling men and women over time.

METHODS

We analysed changes in psychological distress across four time points (2009-2016) using data from HABITAT, a population-representative longitudinal study of adults aged 40-65 in Brisbane, Australia. The analytic sample included 2902 men and 3950 women who completed the Kessler 6 scale. A novel longitudinal neighbourhood social fragmentation index was developed using Australian census data. Sex-specific mixed effects regression models were used to assess associations, adjusting for individual, household, and neighbourhood-level covariates.

RESULTS

Men living in more socially fragmented neighbourhoods had higher mean scores of psychological distress (β = 0.66, 95% CI: 0.28 to 1.04). The effect of neighbourhood social fragmentation on psychological distress among men was stable over time. A trend of higher distress scores for women occurred as the level of neighbourhood social fragmentation increased, however this was not found to be statistically significant (β = 0.25, 95% CI: -0.11 to 0.60).

CONCLUSION

In the context of ageing populations and rising mental health burden, neighbourhood social fragmentation may be a key factor in developing targeted mental health prevention strategies. Our findings suggest differences between men and women in the relationship between neighbourhood social fragmentation and psychological distress; these differences may reflect gendered social experiences. Promoting community cohesion in more socially fragmented areas may help to reduce psychological distress, particularly among men.