Mental Health May Benefit From Greater Access To Public Transportation, Especially If You're A Woman Or Elderly

Public transportation
Italian researchers find good accessibility to public transportation results in fewer depressive symptoms. Tim Savage, CC0 license

We don't know about those MTA delays, but at least living near public transportation is great for mental health, says a new study published in the International Journal of Environmental Research and Public Health.

"Mental health (MH) might be considered one of the most responsive health targets of the urban structure," researchers wrote. "In recent years, studies on BE [built environment] and MH have primarily focused on two measures: residents' perceptions of their living environment and geographical area variations of the quality of the BE. The majority of those studies, however, failed to find statistically significant area effects on MH after accounting for individual socioeconomic factors."

So researchers set for some answers. Using data collected from the Turin Longitudinal Study in northern Italy, which was based in the city's historical population registry from 1971 to present, they looked at five total urban characteristics — developmental density, land use mixture (residential, commercial), public and green space, cultural and sport facilities (public libraries, swimming pools), as well as transit access. Researchers also analyzed basic demographic information, such as education level, job status, population registry data (citizenships), and residential stability (years at the same address).

Adult residents were followed up with regarding antidepressant medications prescribed from Jan. 1, 2004 to Dec. 31, 3006 as a measure of MH, CityLab reported.

The results showed the incidence of depressive symptoms among adults, as measured by any prescription of antidepressant drugs, decreased with improved features of their environments, namely density, which refers to the number of people living in an urban area, and transit access. These two factors were "slightly protective" of MH, especially among women and older residents age 50 to 64.

CityLab cited these particular "populations were prescribed fewer antidepressants when living in areas reached more quickly by bus or train, in places with taller average building heights than those living in more remote or sparse areas." On the other hand, researchers found antidepressant prescriptions increase among those with less education and inactivity.

It could be the effects of city neighborhoods are what researchers call "dose-related."

"Our research has confirmed that women, the elderly and those who have been residentially stable are more affected by their neighborhood environments," they explained. "Fewer prescriptions have been given to women and elderly individuals living in areas well-serviced by public transport. Women, who on average live closer to their workplaces, use more public transport (higher number of trips per day) and walk more in comparison to men."

They continued: "Scholars concerned with equality issues have highlighted the differences in the activities conducted by the two genders during the day. According to Hurez and Richer, ‘the location of men and women in time and space is a reflection of a territory's characteristics,' closely linked to the nature and location of economic activities, but also to the availability of facilities and services."

While CityLab points out this analysis can't pinpoint causal mechanisms, plus the fact antidepressants are "an imprecise proxy for [MH]," it's hard to disagree with the fact buses and trains can relieve the stress of having to drive everywhere, all the while enhancing social connectivity. And when you look strictly at older populations, a city could "inoculate them against feelings of isolation or loneliness." The latter, at any age, has been suggested to increase risk for health conditions, including but not limited to depression.

Researchers concluded: "In order to address health inequalities, urban policies should invest in the delivery of services that enhance resilience factors, above all a good public transport network, in a careful and equal manner, throughout the city."

Source: Melis G, Gelormino E, Marra G, Ferracin E, Costa G. The Effects of the Urban Built Environment on Mental Health: A Cohort Study in a Large Northern Italian City. International Journal of Environmental and Public Health. 2015.

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