Examining the Mediating Role of Neighborhood Cohesion and Trust in the Relationship between Child Deprivation and Depression in the U.S

Background/Purpose: The purpose of this study is to examine the association between child deprivation and depression and how the relationship is mediated by neighborhood cohesion and trust in the United States. Previous studies on child deprivation and depression have consistently found the critical importance of social and environmental contexts in explaining health inequalities among children in socially disadvantaged families. However, little is known about the degree to which social and environmental factors contribute to increasing or decreasing the strength of the association between child deprivation and depression.

Methods: Data used was the Fragile Families and Child Wellbeing Study (FFCWS), which is a nationally representative sample of U.S. children and parents. The study sample consisted of 2,722 children at age 9 and 15 (waves 5 and 6). This study conducted Structural Equation Modeling (SEM) analysis to examine whether levels of neighborhood cohesion and trust mediates the association between child deprivation and depression. Based on Townsend’s relative deprivation theory (1979), child deprivation was conceptualized using 7 items: free food/meals, unable to pay rent, unable to pay utilities, borrowing money, doubling up, not seeing a doctor because of cost, and disconnected telephone service. In addition, guided by Shaw and McKay’s social disorganization theory (1942), neighborhood cohesion and trust were conceptualized using 4 items from 10 neighborhood collective efficacy indicators. Child depression was assessed using an abbreviated form (5 items) based on the full 20 items from the Center for Epidemiologic Studies Depression Scale (CES-D), which is reliable in terms of cross-cultural comparability (FFCWS, 2020).

Results: Findings suggest that neighborhood cohesion and trust significantly mediated the association between child deprivation and depression. The overall SEM model showed a good fit, evidenced by the following fit indices: Satorra-Bentler (S-B) scaled chi-squared = 286.9256 (df=101, p<.001); S-B adjusted CFI=0.967; S-B adjusted TLI=0.961; S-B adjusted RMSEA=0.026. All three direct paths were significant. The direct impact of child deprivation on neighborhood cohesion and trust was -0.226 (p <.05); the direct impact of neighborhood cohesion and trust on child depression was -0.085 (p <.05); the direct impact of child deprivation on child depression was 0.075 (p <.05). The indirect impact of child deprivation on child depression mediated through neighborhood cohesion and trust was 0.019 (=-0.226*-0.085) (p <.05). The total impact of child deprivation on child depression was 0.094 (=0.075+0.019) (p <.05). Taken together, approximately 20% of the total effect associated with child deprivation and child depression was attributed to the inclusion of the neighborhood cohesion and trust.

Conclusions/Implications: Results suggest that neighborhood conditions played a significant role in mediating the association between child deprivation and depression. To alleviate the effect of deprivation on depression of children, in particular those in neighborhoods with concentrated poverty and deprivation, policymakers and social welfare professionals should consider improving neighborhood cohesion and trust as a key policy strategy in the U.S.