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Abstract
Urban environment has now been recognized as significant risk factor of depression; however, there remains a gap in the literature regarding specific stressors associated with urbanization. Therefore, the present study is designated to examine the strength of association between urban environment and depression in temporal manner, and to identify significant risk factors. A household survey based on a questionnaire was conducted in 2003 and 2013, covering 1326 and 1965 households, respectively, from 12 wards of Delhi, India, to procure household-level data. Prevalence of depression was measured using the Centre for Epidemiologic Studies Depression Scale. The individual response rate within participating households was 88.3% in 2003, while it was 82.7% in 2013. During the period of study, the percentage of depressed people increased from 30.9% (2003) to 33.4% (2013). At the univariate level, significant confounders that were associated with depression were being female, unmarried and underemployed. The risk of being depressed due to inaccessibility to basic facilities reduced by − 1.5%, while fear of crime and reducing social support recorded a phenomenal increase of 31.1% and 14.4%, respectively, during the period of study. Within domain analysis, after adjusting for confounding factors, indoor noise pollution (OR 3.04, p < 0.001), overcrowding (OR 2.35, p < 0.001), increasing crime (OR 1.72, p < 0.001), less supportive neighbours (OR 1.16, p < 0.001) and lacking park/playground (OR 1.12, p < 0.001) remained significantly associated with being depressed. This study confirms an association between the urban environment and depression across a range of domains. This study highlights the need to intervene on both physical and social features of urban centres to promote mental well-being.