Urbanicity, Social Connectedness, and Depression in Older Adults: An Analysis of Two African Countries

Johns Hopkins University, Baltimore MD

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Abstract

? DESCRIPTION (provided by applicant): Depression is a significant contributor to global morbidity and mortality and is the primary cause of disability worldwide. Depression accounts for the majority of suicides and also a considerable portion of heart disease. Living in urban settings has been linked to an increased risk of depression and other mental illnesses in numerous studies; however findings have varied and the mechanisms are not well understood. A number of possible contributing factors have been suggested, one being a reduction in social cohesion and social support in urban environments. Older adults are an age group that is more vulnerable to depression, which may be due in part to their greater likelihood of being socially isolated. As the world's population continues to age and with increasing urbanization in low- and middle-income countries, depression is likely to become a growing problem. Using data from African countries participating in the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE), the proposed research therefore seeks to explore the relationship between urbanicity, social connections, and depression among older adults. The study will specifically examine the association between current urban residence and depression and determine whether social cohesion and support explain this association. It will also assess whether urban residence across the life course and at different life stages is associated with depression. Lastly, it will determine whether the relationship between social support and depression varies across urban and rural locations. These aims will be studied through quantitative analyses involving modeling with latent variable and multilevel methods. The proposed research will provide training in advanced analytic techniques and aging-related mental health issues and will support the NIA's Initiative on Global Aging through cross-national research. Results of the study will contribute to understanding the social and contextual determinants of depression in older adults. It will also have important implications for individual and community-level interventions to address late life depression, as well as implications for urban planning policy to promote mental health and for the allocation of mental health resources across urban and rural areas.