The longitudinal effects of neighborhood social and material deprivation change on psychological distress in urban, community-dwelling Canadian adults

INTRODUCTION: Previous research has demonstrated that neighborhood-level exposures can affect mental health outcomes. However, neighborhoods have rarely been examined as time-varying spaces of ecological exposure.  The objective of this study is to examine how changes in neighborhood material and social deprivation affect distress outcomes in adult Canadians.

METHODS: This study examines 2745 participants from Canada's National Population Health Survey, all of whom are urban-, community-dwelling adult Canadians (aged 18 and above at baseline in 2000) who did not move between baseline and follow-up in 2006. Psychological distress was measured at baseline and follow-up using the K6 screening tool. Changes in neighborhood social and material deprivation were measured using the Pampalon Deprivation Index. Associations were analyzed using multivariate linear regressions, controlling for key demographic characteristics, and stratified by baseline deprivation exposure.

RESULTS: At baseline, most participants lived in neighborhoods with low levels of social deprivation, and nearly half of the sample lived in highly materially deprived neighborhoods. Most neighborhoods maintained the same level of social and material deprivation through time. Adjusting for individual characteristics, an improvement of social and material settings was associated with a significant increase in distress scores at follow-up. This association remained positive after controlling for baseline distress scores, but the confidence intervals shifted slightly to cross the null.

CONCLUSIONS: This study suggests that an improvement in neighborhood deprivation, when unplanned and caused by systematically occurring shifts in economic, political, and social environments (i.e. urban gentrification), is associated with worsening psychological distress outcomes. This finding is relevant for urban municipalities, as well as future public health policy. The psychological effects of gentrification should be explored in more detail in future research.