Individual and Neighborhood Characteristics as Predictors of Depression Symptom Response

Document Type


Publication Date



administrative, depression, improvement, neighborhood, Veterans

Digital Object Identifier (DOI)


Objective: Assess whether neighborhood characteristics predict patient-reported outcomes for depression.

Data Sources: VA electronic medical record data and U.S. census data.

Study Design: Retrospective longitudinal cohort.

Data Extraction Methods: Neighborhood and individual characteristics of patients (N = 4,269) with a unipolar depressive disorder diagnosis and an initial Patient Health Questionnaire (PHQ-9) score ≥10 were used to predict 50 percent improvement in 4-8-month PHQ-9 scores.

Principal Findings: The proportion of a patient's neighborhood living in poverty (OR = 0.98; 95% CI: 0.97-.1.00; P = 0.03) was associated with lower likelihood of depression symptom improvement in addition to whether the patient was black (OR = 0.76; 95% CI:0.61-0.96; P = 0.02) had PTSD (OR = 0.59; 95% CI:0.50-0.69; P < 0.001) or had any service-connected disability (OR = 0.73; 95% CI:0.61-0.87; P < 0.001).

Conclusions: Neighborhood poverty should be considered along with patient characteristics when determining likelihood of depression improvement.

Was this content written or created while at USF?


Citation / Publisher Attribution

Health Services Research, v. 54, issue 3, p. 586-591