Independent associations between residential neighbourhood and school characteristics and adolescent mental health in the Netherlands
Brons, M; Bolt, G; Helbich, Marco; Visser, K; Stevens, G
(2022) Health and Place, volume 74, pp. 1 - 17
(Article)
Abstract
This study examined associations between characteristics of the residential neighbourhood and the school and adolescent mental health, including the moderating role of family socioeconomic status (SES) and family support. Nationally representative Dutch data from adolescents aged 12–16 (N = 6422) were analysed through cross-classified multilevel models. Findings showed that school
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characteristics are more strongly linked to adolescent mental health than residential neighbourhood characteristics. More specifically, higher levels of school SES were associated with more hyperactivity-inattention problems, while higher levels of school social disorder were related to more conduct problems and more peer relationship problems. Further, higher levels of school SES were associated with more emotional symptoms only for adolescents with a relatively low family SES. Higher levels of neighbourhood SES were associated with fewer peer relationship problems. Overall, there was little evidence for the moderating role of family SES or family support.
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Keywords: Adolescent mental health, Air pollution, Greenspace, Neighbourhood, School, Social disorder, Social environment, Socioeconomic status, Health(social science), Sociology and Political Science, Life-span and Life-course Studies
ISSN: 1353-8292
Publisher: Elsevier
Note: Funding Information: Marco Helbich was funded by the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (grant agreement No. 714993 ). Funding Information: Five CCMMs were fitted per mental health outcome. Model 1 only included control variables. Model 2 additionally added neighbourhood-level variables, while Model 3 included school-level variables. Model 4 included control, neighbourhood-, and school-level variables simultaneously. In Model 5 only significant cross-level interactions between family SES, family support, and the neighbourhood- and school-level variables were added. In order to assess Model 5, we excluded the nonsignificant cross-level interactions from the model one by one to keep the model parsimonious. If a cross-level interaction term was statistically significant, we plotted the marginal effects and performed stratified adjusted regressions to test whether the associations varied across three subgroups based on family SES and family support (1 SD below average, average, and 1 SD above average). Family SES, family support, and the neighbourhood- and school-level variables were grand-mean centred for the cross-level interactions. We used a Benjamini-Hochberg correction to correct for multiple testing at α = 0.05 across all models. All analyses were performed in R, version 4.0.3 (R Core Team, 2020), using the “lme4” package (Bates et al., 2012).Model 1 in Table 3 showed that adolescents with lower levels of family SES and family support, who were older, not living together with both biological parents, and girls reported more emotional symptoms. None of the neighbourhood characteristics were associated with emotional symptoms (Model 2). Model 3 indicated that higher school SES was associated with more emotional symptoms. This association remained significant after adjusting for neighbourhood characteristics (Model 4). Model 5 revealed a cross-level interaction between family SES and school SES. In Fig. A3, the marginal effects indicated that estimated coefficients for the association between school SES and emotional problems were positive in the lower ranges of family SES and were absent or slightly negative for adolescents from higher SES families. In line with this, subsequent analyses showed that the positive association between school SES and emotional symptoms was significant only for those with 1 SD below average family SES (b = 0.064, p < .001).Model 1 in Table 6 showed that adolescents from lower SES families, with less family support, who were older, wo where living in an urban neighbourhood, and were enrolled in lower educational levels reported more peer relationship problems. No significant associations were observed between neighbourhood-level variables and peer relationship problems in Model 2. Higher levels of school social disorder were associated with more peer relationship problems (Model 3). This association remained significant after neighbourhood variables were included in the Model (Model 4). Moreover, in Model 4, higher levels of neighbourhood SES were associated with fewer peer relationship problems.We expected the associations of residential neighbourhood and school characteristics with mental health outcomes to vary according to family SES or family support. For five out of possibly ninety-six interactions, the association between either residential neighbourhood or school characteristic and adolescent mental health varied across family SES or family support. However, we only found two cross-level interactions for which a significant association was observed between either residential neighbourhood or school characteristics and a mental health outcome for at least one subgroup. For adolescents with below average family SES, higher levels of school SES were associated with more emotional symptoms, whilst there was no association between school SES and emotional symptoms for adolescents with average or above average family SES. Further, no association between school-level classmate support and peer relationship problems was observed for adolescents with average or below average family support, while for those with above average family support higher levels of school-level classmate support were associated with fewer peer relationship problems.Overall, our results on the moderating roles of family SES and family support indicated that the contextual effects hardly vary across these individual-level factors suggesting that individual effects and contextual effects work independently from each other. The first interaction between school and family SES and emotional symptoms has been interpreted above. Contradicting the notion of accumulation of disadvantages, our second cross-level interaction revealed that for adolescents with above average family support, higher levels of school-level classmate were associated with fewer peer relationship problems indicating an accumulation of advantages.This study contributed significantly to our understanding of the association between residential neighbourhood and school characteristics and adolescent mental health by assessing both contexts simultaneously. Our findings suggest that the school context is of greater importance to adolescent mental health than the residential neighbourhood context. Especially school characteristics concerning social processes were associated with adolescent mental health. Higher levels of school social disorder were related to more conduct problems and more peer relationship problems. Also, higher levels of school SES were associated with more hyperactivity-inattention problems, while higher levels of school SES were associated with more emotional symptoms only for adolescents with a low family SES. There was little evidence for the moderating role of family SES and family support. Our findings imply that adolescent mental health interventions taking place at schools possibly have the potential to be more effective than those in neighbourhoods, especially when they are aimed at social processes.Marco Helbich was funded by the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (grant agreement No. 714993). Publisher Copyright: © 2022 The Authors
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