Urbanicity is Associated with Behavioral and Emotional Problems in Elementary School-Aged Children
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Adults are 38% more likely to suffer from a psychiatric disorder when they live in an urban compared to a rural area. Urban upbringing may be particularly important. The aim of the present study was to examine whether urbanicity was independently associated with mental health in elementary school-aged children. Specifically, we investigated whether living in a more urban area was associated with exhibiting more behavioral and emotional problems, and whether this remained while controlling for other major risk factors for mental health problems in children. Data came from a Dutch general population study of children (n = 895). Information from four waves was used, in which children were aged approximately 8, 9, 11, and 12 years old. We used mixed effects models to assess the association between urbanicity and the outcomes of behavioral problems and emotional problems separately, while controlling for other major risk factors. The analyses showed that children who lived in more urban areas were significantly more likely to exhibit behavioral (p < .001) and emotional (p < .001) problems. This effect remained when controlling for neighborhood socioeconomic status, gender, ethnicity, family socioeconomic status, parental symptoms of psychopathology, parenting stress, and parenting practices (behavioral: p = .02, emotional: p = .009). In line with research in adults, urbanicity seems to be independently associated with behavioral and emotional problems in children. A possible underlying mechanism is that the city is a stressful environment for children to grow up in, which contributes to an increased risk for mental health problems.
KeywordsUrbanicity Children Mental health Behavioral problems Emotional problems
We would like to thank all participants of the Spelregels study, their parents and teachers. This study was financially supported by the Netherlands Organization for Health Research and Development Grants #26200002 and #120620029.
B.E.: designed the research questions for the current study, performed the data analyses and wrote the paper. J.B.: assisted with the data analyses, collaborated with the writing of the methods and results and collaborated with the editing of the final manuscript. W.B.: collaborated with the design of the research questions, assisted with the data analyses and collaborated with the editing of the final manuscript. A.C.: collaborated with the writing and editing of the final manuscript. P.L.: acquired funding for the larger study of which the current study was a part, designed the larger study, collaborated with the design of the current research questions and collaborated with the writing and editing of the final manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
The parents of all children included in the study gave informed consent at the beginning of their child’s participation in the study. For each subsequent data collection wave, parents were informed of the data collection plans and were given the opportunity to revoke the inclusion of their child or themselves in the study.
- Ashford, J., Smit, F., van Lier, P. A. C., Cuijpers, P., & Koot, H. M. (2008). Early risk indicators of internalizing problems in late childhood: A 9-year longitudinal study. Journal of Child Psychology and Psychiatry, 49(7), 774–780. https://doi.org/10.1111/j.1469-7610.2008.01889.x.CrossRefPubMedGoogle Scholar
- Bates, D., Maechler, M., & Bolker, B. (2011). lme4: Linear mixed-effects models using S4 classes. (R package version 0.999375-42 ed.).Google Scholar
- Bliese, P. (2000). Within-group agreement, non-independence, and reliability: Implications for data aggregation and analysis. In K. J. Klein & S. W. Kozlowski (Eds.), Multilevel theory, research, and methods in organizations (pp. 349–381). San Francisco, CA: Jossey-Bass, Inc.Google Scholar
- Bliese, P. (2013). Multilevel: Multilevel Functions. R Package version 2.5.Google Scholar
- Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., & Israel, S., et al. (2014). The p factor: One general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science, 2(2), 119–137. https://doi.org/10.1177/2167702613497473.CrossRefPubMedPubMedCentralGoogle Scholar
- De Brock, A. J. L. L., Vermulst, A. A., Gerris, J. R. M., & Abidin, R. R. (1992). Nijmeegse Ouderlijke Stress Index (Nijmegen Parental Stress Index). Lisse: Swets & Zeitlinger.Google Scholar
- Duncan, G. J., Magnuson, K., & Votruba-Drzal, E. (2016). Children and socioeconomic status. In M. H. Bornstein & T. Leventhal (Eds.), Handbook of child psychology and developmental science Vol.4 (pp. 534–574). Hoboken, New Jersey: Wiley.Google Scholar
- Dunham, H. W. (1965). Community and Schizophrenia. Detroit, MI: Wayne State University Press.Google Scholar
- Eaton, N. R., Keyes, K. M., Krueger, R. F., Balsis, S., Skodol, A. E., & Markon, K. E., et al. (2012). An invariant dimensional liability model of gender differences in mental disorder prevalence: Evidence from a national sample. Journal of Abnormal Psychology, 121(1), 282–288. https://doi.org/10.1037/a0024780.CrossRefPubMedGoogle Scholar
- Eaton, N. R., Keyes, K. M., Krueger, R. F., Noordhof, A., Skodol, A. E., & Markon, K. E., et al. (2013). Ethnicity and psychiatric comorbidity in a national sample: Evidence for latent comorbidity factor invariance and connections with disorder prevalence. Social Psychiatry and Psychiatric Epidemiology, 48(5), 701–710. https://doi.org/10.1007/s00127-012-0595-5.CrossRefPubMedGoogle Scholar
- Erasmus University Medical Center. (2000). Problem Behavior at School Interview. Rotterdam: Department of Child and Adolescent Psychiatry, Erasmus University Medical Center.Google Scholar
- Hill, A. B. (1965). Environment and disease - Association or causation. Proceedings of the Royal Society of Medicine-London, 58(5), 295–300.Google Scholar
- Kalff, A. C., Kroes, M., Vles, J. S. H., Hendriksen, J. G. M., Feron, F. J. M., & Steyaert, J., et al. (2001). Neighbourhood level and individual level SES effects on child problem behaviour: A multilevel analysis. Journal of Epidemiology and Community Health, 55(4), 246–250. https://doi.org/10.1136/jech.55.4.246.CrossRefPubMedPubMedCentralGoogle Scholar
- Kendler, K. S., Aggen, S. H., Knudsen, G. P., Roysamb, E., Neale, M. C., & Reichborn-Kjennerud, T. (2011). The structure of genetic and environmental risk factors for syndromal and subsyndromal common DSM-IV Axis I and All Axis II disorders. American Journal of Psychiatry, 168(1), 29–39. https://doi.org/10.1176/appi.ajp.2010.10030340.CrossRefPubMedGoogle Scholar
- Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., & Normand, S. L. T., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. https://doi.org/10.1017/s0033291702006074.CrossRefPubMedGoogle Scholar
- Kessler, R. C., Ormel, J., Petukhova, M., McLaughlin, K. A., Green, J. G., & Russo, L. J., et al. (2011). Development of lifetime comorbidity in the World Health Organization World Mental Health Surveys. Archives of General Psychiatry, 68(1), 90–100. https://doi.org/10.1001/archgenpsychiatry.2010.180.CrossRefPubMedPubMedCentralGoogle Scholar
- Lahey, B. B., Van Hulle, C. A., Singh, A. L., Waldman, I. D., & Rathouz, P. J. (2011). Higher-order genetic and environmental structure of prevalent forms of child and adolescent psychopathology. Archives of General Psychiatry, 68(2), 181–189. https://doi.org/10.1001/archgenpsychiatry.2010.192.CrossRefPubMedPubMedCentralGoogle Scholar
- Lai, D.-C., Tseng, Y.-C., Hou, Y.-M., & Guo, H. R. (2012). Gender and geographic differences in the prevalence of autism spectrum disorders in children: Analysis of data from the national disability registry of Taiwan. Research in Developmental Disabilities, 33(3), 909–915. https://doi.org/10.1016/j.ridd.2011.12.015.CrossRefPubMedGoogle Scholar
- Leventhal, T., Dupere, V., & Shuey, E. A. (2016). Children in neighborhoods. In M. H. Bornstein & T. Leventhal (Eds.), Handbook of child psychology and developmental science (pp. 493–533). Hoboken, N.J.: Wiley.Google Scholar
- Newbury, J., Arseneault, L., Caspi, A., Moffitt, T. E., Odgers, C. L., & Fisher, H. L. (2016). Why are children in urban neighborhoods at increased risk for psychotic symptoms? Findings from a UK longitudinal cohort study. Schizophrenia Bulletin, 42(6), 1372–1383. https://doi.org/10.1093/schbul/sbw052.CrossRefPubMedPubMedCentralGoogle Scholar
- Odgers, C. L., Caspi, A., Russell, M. A., Sampson, R. J., Arseneault, L., & Moffitt, T. E. (2012). Supportive parenting mediates neighborhood socioeconomic disparities in children’s antisocial behavior from ages 5 to 12. Development and Psychopathology, 24(3), 705–721. https://doi.org/10.1017/s0954579412000326.CrossRefPubMedPubMedCentralGoogle Scholar
- Pujol, S., Levain, J. P., Houot, H., Petit, R., Berthillier, M., & Defrance, J., et al. (2014). Association between ambient noise exposure and school performance of children living in an urban area: A cross-sectional population-based study. Journal of Urban Health-Bulletin of the New York Academy of Medicine, 91(2), 256–271. https://doi.org/10.1007/s11524-013-9843-6.PubMedGoogle Scholar
- R Core Team. (2015). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.Google Scholar
- Ravens-Sieberer, U., Wille, N., Erhart, M., Bettge, S., Wittchen, H.-U., & Rothenberger, A., et al. (2008). Prevalence of mental health problems among children and adolescents in Germany: Results of the BELLA study within the National Health Interview and Examination Survey. European Child & Adolescent Psychiatry, 17(1), 22–33. https://doi.org/10.1007/s00787-008-1003-2.CrossRefGoogle Scholar
- Reijneveld, S., Harland, P., Brugman, E., Verhulst, F., & Verloove-Vanhorick, S. (2005). Psychosocial problems among immigrant and non-immigrant children - Ethnicity plays a role in their occurrence and identification. European Child & Adolescent Psychiatry, 14(3), 145–152. https://doi.org/10.1007/s00787-005-0454-y.CrossRefGoogle Scholar
- Reijneveld, S. A., Veenstra, R., de Winter, A. F., Verhulst, F. C., Ormel, J., & de Meer, G. (2010). Area deprivation affects behavioral problems of young adolescents in mixed urban and rural areas: The TRAILS study. Journal of Adolescent Health, 46(2), 189–196. https://doi.org/10.1016/j.jadohealth.2009.06.004.CrossRefPubMedGoogle Scholar
- Rudolph, K. E., Stuart, E. A., Glass, T. A., & Merikangas, K. R. (2014). Neighborhood disadvantage in context: The influence of urbanicity on the association between neighborhood disadvantage and adolescent emotional disorders. Social Psychiatry and Psychiatric Epidemiology, 49(3), 467–475. https://doi.org/10.1007/s00127-013-0725-8.CrossRefPubMedGoogle Scholar
- Statistics Netherlands (2001). Working Population Classifications of Occupations Scheme. Den Haag/Heerlen.Google Scholar
- Statistics Netherlands (2015). Statline. www.statline.cbs.nl. Den Haag/Heerlen.
- Statistics Netherlands (2016). Neighborhood Area. Den Haag/Heerlen.Google Scholar
- Stone, L. L., Mares, S. H. W., Otten, R., Engels, R., & Janssens, J. (2016). The co-development of parenting stress and childhood internalizing and externalizing problems. Journal of Psychopathology and Behavioral Assessment, 38(1), 76–86. https://doi.org/10.1007/s10862-015-9500-3.CrossRefPubMedGoogle Scholar
- Lumley, T., Diehr, P., Emerson, S., & Chen, L. (2002). The importance of the normality assumption in large public health data sets. Annual Review of Public Health, 23(1), 151–169. https://doi.org/10.1146/annurev.publhealth.23.100901.140546.CrossRefPubMedGoogle Scholar
- United Nations (2014). World Urbanization Prospects: The 2014 Revision, Highlights (ST/ESA/SER.A/352).Google Scholar
- Witvliet, M., van Lier, P. A. C., Cuijpers, P., & Koot, H. M. (2009). Testing links between childhood positive peer relations and externalizing outcomes through a randomized controlled intervention study. Journal of Consulting and Clinical Psychology, 77(5), 905–915. https://doi.org/10.1037/a0014597.CrossRefPubMedGoogle Scholar