Citation

Lovasi GS, Mooney SJ, Muennig P, DiMaggio C. Soc. Psychiatry Psychiatr. Epidemiol. 2016; 51(12): 1571-1579.

Affiliation

Division of Trauma, Emergency Surgery and Surgical Critical Care, New York University School of Medicine, New York, USA.

Copyright

(Copyright © 2016, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00127-016-1300-x

PMID

27787585

Abstract

OBJECTIVES: Our surroundings affect our mood, our recovery from stress, our behavior, and, ultimately, our mental health. Understanding how our surroundings influence mental health is central to creating healthy cities. However, the traditional observational methods now dominant in the psychiatric epidemiology literature are not sufficient to advance such an understanding. In this essay we consider potential alternative strategies, such as randomizing people to places, randomizing places to change, or harnessing natural experiments that mimic randomized experiments.

METHODS: We discuss the strengths and weaknesses of these methodological approaches with respect to (1) defining the most relevant scale and characteristics of context, (2) disentangling the effects of context from the effects of individuals' preferences and prior health, and (3) generalizing causal effects beyond the study setting.

RESULTS: Promising alternative strategies include creating many small-scale randomized place-based trials, using the deployment of place-based changes over time as natural experiments, and using fluctuations in the changes in our surroundings in combination with emerging data collection technologies to better understand how surroundings influence mood, behavior, and mental health.

CONCLUSIONS: Improving existing research strategies will require interdisciplinary partnerships between those specialized in mental health, those advancing new methods for place effects on health, and those who seek to optimize the design of local environments.

Language: en