Individual and Interactive Effects of Housing and Neighborhood Quality on Mental Health in Hong Kong: A Retrospective Cohort Study

• Published in: Journal of urban health Vol. 101; no. 4; pp. 804 - 814
• Main Authors: Wong, Corine Sau Man, Chan, Wai Chi, Chu, Natalie Wing Tung, Law, Wing Yan, Tang, Harriet Wing Yu, Wong, Ting Yat, Chen, Eric Yu Hai, Lam, Linda Chiu Wa
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2024; Springer Nature B.V
• Subjects: Cohort analysis; Epidemiology; Generalized linear models; Health Informatics; Housing; Medicine; Medicine & Public Health; Mental disorders; Mental health; Neighborhoods; Original; Original Article; Psychological stress; Public Health; Regression analysis; Residential areas; Residential communities; Statistical models; Urban environments; Hong Kong China; China; Urban environment; Housing; Mental health; Neighborhood
• ISSN: 1099-3460; 1468-2869; 1468-2869
• DOI: 10.1007/s11524-024-00869-5

Existing literature has widely explored the individual roles of housing and neighborhood quality, and there is limited research examining their interactive effects on mental health. This 3-year cohort study utilized a longitudinal design to investigate the individual and interactive effects of housing and neighborhood quality on mental health among 962 community-dwelling adults in Hong Kong. Participants were asked to rate their residential qualities over the 3-year period. Mental health outcomes, including levels of psychological distress and common mental disorders (CMD), were assessed using the Revised Clinical Interview Schedule (CIS-R). Logistic regression and generalized linear models were used to examine the association between housing and neighborhood quality and CMD/psychological distress, adjusting for sociodemographic and residential characteristics and baseline mental disorders. Housing quality was associated with the 3-year CMD (adjusted OR 0.95; 95% CI 0.91 to 0.98). Likewise, neighborhood quality was associated with CMD over 3 years (adjusted OR 0.92; 95% CI 0.87 to 0.96). In a separate model including both quality measures, the effect of housing quality on CMD was attenuated, whereas the neighborhood impact remained significant (adjusted OR 0.92; 95% CI 0.87 to 0.98). Generalized linear models indicated that for participants residing in substandard housing, those with high neighborhood quality had lower CIS-R scores at follow-up compared to those with low neighborhood quality ( p = 0.041). Better neighborhood quality alleviated the detrimental effects of poor housing quality on mental health. Planning for an enhanced neighborhood would improve population mental health in an urban environment.