Research also indicated a reciprocal effect, that is, people who had poor health or who experienced difficult life events (e.g. Selective migration may lead to worse population health in those neighborhoods that movers leave behind and to better health at the destination, as movers often have better health status ( e5, e6). However, it is important to keep in mind that correlation is not causation. Evidence also exists for socially disorganized neighborhoods in which people feel insecure and frequently experience violence ( e1, e2), contributing to increased trauma exposure with related consequences for mental health ( 40, e3, e4). Persons within disadvantaged areas may have more difficulties building and sustaining supportive social relationships and may have increasing susceptibility to mental illness. In another study, adverse conditions associated with very poor neighborhoods in slums were associated with mental health disorders in India ( 39).
The association between familial liability and mental illness was stronger in more deprived neighborhoods, with neighborhood variables mediating urbanicity effects in Turkey ( 38). depression, schizophrenia) versus living in richer neighborhoods ( 27, 29, 33, 35– 40, e1– e4). For example, living in poor or deprived neighborhoods is associated with greater risk of poor mental health (e.g. SES is by far the most studied risk factor and has been consistent in its association with mental health. perceived minority status, ethnic group membership) ( 27– 34). In contrast, rural residents were more likely to have alcohol dependence than were urban residents, as shown in a study in China ( 8). Addictive disorders (for instance excessive use of massive multiplayer online role-playing games ) was mainly found among young adult university graduates living alone in urban France ( 26). This was also true in a study on common perinatal mental disorders (depression and substance use) in women in Vietnam ( 25). In contrast, rural residents in China were more likely to have depressive disorders ( 8, 24).
Likewise, mood disorders were observed more frequently among residents of large cities in Germany ( 12).
Epidemiological studies further confirmed that the risk for schizophrenia was higher in people who grew up in cities (versus rural areas), thereby exhibiting a dose-response relationship: The more time spent in an urban environment as a child, the higher the risk for schizophrenia as an adult ( 15– 23). In a Danish study, the risk for schizophrenia was more than twofold for individuals who had spent their first 15 years in a major city versus those who had grown up in rural areas ( 14) (see the Table for a selective summary). schizophrenia) in China ( 11) and in large urban areas in Germany ( 12, 13). The same was true for psychotic disorders (e.g. Studies on anxiety disorders (including posttraumatic stress disorder, distress, anger, and paranoia) found higher rates in urban versus rural areas in several Latin American and Asian countries ( 7– 10). anxiety, psychotic, mood, or addictive disorders) is generally higher in cities (e.g. The risk for some major mental illnesses (e.g.
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