Changing neighborhood income deprivation over time, moving in childhood and adult risk of depression

Clive E Sabel, Carsten Bøcker Pedersen, Sussie Antonsen, Roger Webb, Henriette Thisted Horsdal

Research output: Contribution to journalArticlepeer-review

Abstract

Importance
Complex biological, socioeconomic and psychological variables combine to cause mental illnesses; with mounting evidence that early-life experiences are related to adulthood mental health.

Objective
To determine whether changing neighborhood income deprivation and residential moves during childhood are associated with risk of being diagnosed with depression in adulthood.

Design
Individuals were followed from their 15th birthday until either death, emigration, depression diagnosis, or December 31, 2018. Longitudinal residential location was obtained by linking all individuals to the Danish longitudinal population register.

Setting
The whole population cohort of 1,096,916 people born in Denmark, 1981-2001, who resided in the country during the first 15 years of life.

Participants
35,098 individuals developed depression during follow-up.

Exposures
A neighborhood income deprivation index at place of residence for each year of age from 0-15, and a mean income deprivation index for the entire childhood ( aged 0-15).Residential moves were considered by defining ‘stayers’ as individuals who lived in the same Data Zone during their entire childhood, ‘movers’ otherwise.

Main Outcomes and Measures
Multilevel survival analysis determined associations between neighborhood-level income deprivation and incidence rates, after adjustment for individual factors. Results were reported as incidence rate ratios (IRRs). The hypotheses were formulated before data collection.

Results
A total of 1,096,916 (males: 563,864 [51.4%]) individuals were followed from age 15. During follow-up, 35,098 (females: 23,728 [67.6%]) were diagnosed with depression. People from deprived areas during childhood had an increased risk of depression (IRR 1.10, 95% CI: 1.08-1.12). Following full individual-level adjustment the risk was attenuated (IRR of 1.02, 95% CI: 1.01-1.04), indicating an increase of 2% in depression incidence for each standard deviation increase in income deprivation. Moving during childhood, independent of neighborhood deprivation status, was associated with significantly higher rates of depression in adulthood, compared to non-movers, (IRR 1.61, 95% CI: 1.52-1.1.70) for 2 or more moves after full adjustment.

Conclusions and Relevance.
Rather than just low or changing neighborhood income deprivation trajectories in childhood driving adulthood depression, those individuals with an unsettled home environment in childhood are more likely to develop depression in adulthood. Policies that enable and support settled childhoods should be promoted.
Keywords (5):
Depression; Social context; Residential mobility; Population registers; Danish longitudinal Deprivation Index

Original languageEnglish
JournalJAMA Psychiatry
DOIs
Publication statusPublished - 17 Jul 2024

Keywords

  • Depression
  • Social context
  • Residential movility
  • Population registers
  • Danish Longitudinal Deprivation Index

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