The relationship between urbanization and depression in China: The mediating role of neighborhood social capital

Abstract

Background: Previous studies in developed countries have found that living in rapidly urbanizing areas is associated with higher risk of mental illness and that social capital had a protective effect on individual mental health. However, the literature is missing empirical studies of the relationship between urbanization, neighborhood social capital and mental health in rapidly urbanizing countries. To bridge this knowledge gap, this study investigated the effects of urbanization on depressive symptoms in China, with an emphasis on the mediating role of neighborhood social capital in the relationship between urbanization and individual-level depressive symptoms. Methods: Nationally representative survey data from the 2016 wave of China's Labor-force Dynamics Survey were used. A sample of 20,861 individuals was obtained from 401 neighborhoods in 158 prefecture-level divisions of 29 provinces. Depressive symptoms were measured using CES-D scores. Neighborhood social capital was assessed by three individual-level variables aggregated to the neighborhood level: perceptions of neighborly trust, the extent of neighborly reciprocity, and membership to neighborhood social groups. Multilevel linear regression and mediation analyses were used to estimate the statistical relationships. Results: The multilevel linear regression analyses found negative relationships between urbanization rate and CES-D score. The mediation analysis found that neighborhood-level social capital was an inconsistent mediator in the relationship between urbanization rate and CES-D score. Interaction terms between urbanization rate and two measures of neighborhood-level social capital were statistically significant, indicating that the protective effects of neighborly reciprocity and membership to neighborhood social groups on CES-D scores (negative relationships) were stronger in the relatively more urbanized areas. Conclusion: Urbanization supports mental health in the Chinese context, although it might undermine residents' mental health by reducing neighborhood social capital. The protective effect of neighborhood-level reciprocity and social group membership on mental health increased with urbanization.