Urbanization, urbanicity, and depression: a review of the recent global literature

One of the defining trends of population movement in the last half century has been global urbanization. Depression is the most common mental disorder in the world, but it is unclear how urbanization and urban living affect depression outcomes. Grounded in a previously articulated conceptual framework, we systematically reviewed recently published studies on urbanization, urbanicity, and depression.

Eleven articles were included in this review. Four studies found that living in urban areas was associated with elevated odds or more symptoms of depression. Three studies - all done in China - estimated protective effects of urbanization or urbanicity on depression. Two studies concluded no overall clear association. The remaining two articles stratified by urbanicity and found that greenspace was inversely associated with depression in more densely populated areas relative to rural areas. Other themes discussed included global and national trends such as aging, immigration, and planned urbanization in China, as well as urban living conditions such as traffic noise, air pollution, proximity to roadways, neighborhood social capital, and social cohesion.

Urbanization may affect depression differentially across geographic regions and income levels. More research is needed, particularly in low-income and middle-income countries, and on intersections between urbanization and other emerging global trends.