The impact of family & neighborhood on mental health (2 studies)

Today I learned about a study that shows that moving poor families to rich areas can have a big impact on the children, check this abstract:

The Moving to Opportunity (MTO) experiment offered randomly selected families living in high-poverty housing projects housing vouchers to move to lower-poverty neighborhoods. We present new evidence on the impacts of MTO on children’s long-term outcomes using administrative data from tax returns. We find that moving to a lower-poverty neighborhood significantly improves college attendance rates and earnings for children who were young (below age 13) when their families moved. These children also live in better neighborhoods themselves as adults and are less likely to become single parents. The treatment effects are substantial: children whose families take up an experimental voucher to move to a lower-poverty area when they are less than 13 years old have an annual income that is $3,477 (31%) higher on average relative to a mean of $11,270 in the control group in their mid-twenties. In contrast, the same moves have, if anything, negative long-term impacts on children who are more than 13 years old when their families move, perhaps because of disruption effects. The gains from moving fall with the age when children move, consistent with recent evidence that the duration of exposure to a better environment during childhood is a key determinant of an individual’s long-term outcomes. The findings imply that offering families with young children living in high-poverty housing projects vouchers to move to lower-poverty neighborhoods may reduce the intergenerational persistence of poverty and ultimately generate positive returns for taxpayers.

This coincides with another study just published in Journal of Psychiatric Research in which a team of researchers from Sweden and the United States have examined the potential role of the family environment and neighborhood factors on mental health outcomes in a new study published.

In short:

 

  • They followed 542,195 children for 11 years and 4.8% developed a psychiatric disorder.
  • High neighborhood deprivation was associated with a 2-fold risk of conduct disorder.
  • High neighborhood deprivation was not associated with ADHD.
  • Psychiatric disorders were even more influenced by familial than neighborhood effects.
  • Familial effects were stronger for externalizing than internalizing disorders.

 

From the press release:

The study includes highly detailed data on over 500,000 children in Sweden and covers a timespan of more than a decade.

A total of 542,195 children were tracked for 11 years for incident internalizing (anxiety and mood) and externalizing (ADHD and conduct) disorders. During the course of the study, 4.8 percent of the children developed a psychiatric disorder.

Key findings from the study include that high neighborhood deprivation was associated with a 2-fold higher risk of conduct disorder, a 40% increased risk of anxiety disorder and a 20% increased risk of mood disorders, after adjustment for individual factors. Moderate neighborhood deprivation was associated with a 30% increased risk of ADHD, after adjustments.

“However, we also found that familial random effects, including both genetic and family environmental factors, accounted for six to eight times as much of the total variation in psychiatric disorders, compared with neighborhood random effects,” said Professor Jan Sundquist, who led the research.

“The estimated risks and random effects indicate that children are strongly affected by both their family and neighborhood environments and that the former seems to be more important at a population level,” Sundquist continued.

One of the strengths of the study is that it based on data from Sweden’s multiple population and health care registers, which are highly complete and valid and, crucially, help to avoid bias from self-reporting.

“With such a rich amount of data at our disposal we have been able carry out a comprehensive study that answers many probing questions about the mental health of young people in Sweden,” added Sundquist.

Further research is necessary argue the academics, particularly regarding intervention strategies in early life. In the meantime Sundquist and his team have suggested that their findings should help shape policies to promote mental health by factoring in potential influences from both family and neighborhood environments.

Abstract of this second study:

Background

More knowledge is needed on potential associations between individual-, family-, and neighborhood-level factors and psychiatric disorders in children and adolescents.

Aims

To examine associations between, individual-, family-, and neighborhood-level factors and incident internalizing (anxiety and mood) disorders and externalizing (ADHD and conduct) disorders in children and adolescents, and to estimate the relative contributions of family and neighborhood to individual variation in these disorders.

Method

We performed a three-level logistic regression on all 542,195 children born in Sweden in 1992–1996, nested in 427,954 families, which in turn were nested in 8475 neighborhoods. The children were followed from 2000 to 2010 for incident internalizing and externalizing psychiatric disorders, assessed from medical records.

Results

26,514 children (4.8%) were diagnosed with internalizing or externalizing psychiatric disorders. Approximately 29% of the total individual variance in internalizing disorders could be attributed to the family level, which includes both genetic and family environmental effects, and 5% to the neighborhood level. The corresponding figures for externalizing disorders were 43.5% and 5.5%, respectively. After adjustment for individual-level sociodemographic factors, high neighborhood deprivation was associated with increased risks of externalizing and internalizing psychiatric disorders (odds ratio [OR] = 1.37, 95% credible interval [CI] = 1.25–1.50 and OR = 1.34, 95% CI = 1.25–1.45, respectively), including conduct disorder (OR = 2.01, 95% CI = 1.58–2.55), anxiety disorders (OR = 1.40, 95% CI = 1.29–1.52), and mood disorders (OR = 1.21, 95% CI, 1.09–1.35). The strongest association between neighborhood deprivation and ADHD was observed in moderately deprived neighborhoods (OR = 1.31, 95% CI = 1.19–1.44).

Conclusions

These findings call for policies to promote mental health that consider potential influences from children’s family and neighborhood environments.conclusion

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