Evaluation of sensitive period, accumulation, and social mobility mechanisms linking neighborhood socioeconomic deprivation to mental health during adolescence and young adulthood: A life-course, causal inference approach

Little is known about how young people's mental health is associated with exposure to neighborhood socioeconomic deprivation early in life. We addressed this gap by examining three life course mechanisms—sensitive period, accumulation, and social mobility—to assess whether the timing, duration, and direction of changes in exposure to neighborhood deprivation are associated with externalizing and internalizing problems during adolescence and young adulthood. Seven survey waves of a Dutch cohort (TRAILS, n=2229) were used. We applied structural nested mean models with G-estimation to address time-varying confounding (i.e., exposure-induced confounding). Both the timing and changes in exposure to neighborhood deprivation were associated with mental health problems, whereas exposure duration appeared irrelevant. In sensitive period models, higher deprivation at age 16 was associated with more internalizing problems at age 16, while higher deprivation at age 19 was related to more internalizing problems at age 29. Social mobility models showed that, compared to adolescents with residential social stability, moving to more deprived neighborhoods from age 16 to 19 was associated with more externalizing problems at age 26. From age 19 to 22, both upward and downward moves were associated with fewer internalizing problems at age 29 than residential stability, suggesting a potential role of residential moving itself. Overall, these findings suggest that late adolescence and the transition to adulthood may constitute a sensitive period for the potential influence of exposure to, and changes in exposure to, neighborhood deprivation on mental health. Neighborhood-level interventions targeting this period may be particularly effective for promoting mental health.