Associations between neighborhood socioeconomic status with depressive symptoms, and psychological distress among Asian American adults in New York City

Abstract

Abstract The relationship between neighborhood socioeconomic status (NSES) with mental health among Asian Americans (AA) is underexamined. We sought to determine whether NSES is associated with symptoms of psychological distress or depression among AA residents of New York City (NYC). We examined 4,557 Chinese, Asian from the Indian Subcontinent (ISC), or Other Asian participants of the NYC Community Health Survey, 2018–2020. Participants self-reported psychological distress using the (Kessler-6 (K6)) and depressive symptoms using the Patient Health Questionnaire-8 (PHQ8), with higher scores indicating worse mental health. The neighborhood was defined by residence in one of 55 districts. We constructed a NSES factor score from neighborhood levels of: unemployment, poverty, high rent burden, and a college or greater education. NSES was categorized into tertiles. Hierarchical linear models assessed associations between NSES and mental health, adjusted for individual level age, sex, income, education, nativity, body mass index, current drinking, current smoking, and physical activity. Among NYC AA residents, 52% were women, 45% were 25–44 years old, 25% had less than high school education, and 56% lived in poverty. Living in a high compared with low NSES tertile associated with a lower PHQ8 scores (beta: -0.65; 95% CI: -1.10,-0.19) among Chinese NYC residents and a higher K6 score (beta 1.27; 95% CI: 0.59,1.95) among Asians from the ISC NYC residents. In NYC, living in low NSES neighborhoods was associated with less depression symptoms among Chinese Americans, and greater psychological distress among Asians from the ISC. These results underscore that neighborhood context is associated with mental health and that aggregation of AA into one group can obscure important associations.