The protective role of community cohesion across rural and urban contexts: implications for youth mental health.

Abstract

Background: Exposure to adversity (e.g., negative life events) and socioeconomic disadvantage can increase the risk for internalizing and externalizing symptoms, but many youth demonstrate resilience. Risk and protective factors may vary depending on geographic contexts (i.e., urban vs. rural areas). We hypothesized that community cohesion would mitigate the effects of adversity and disadvantage on youth mental health symptoms, especially among rural communities.

Method: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study (n = 10,812), a longitudinal study in the United States. At baseline (9-10 years old), neighborhood socioeconomic disadvantage was measured with the Area Deprivation Index, and youth reported on the total number of negative life events they had experienced. At the 2-year follow-up, caregivers reported on cohesion within their community, and at the 3-year follow-up, they reported on their child's internalizing and externalizing symptomatology. A multiple-group path model was used to compare effects for youth living in urban versus rural areas.

Results: In the urban subsample, results indicated a significant interaction between neighborhood disadvantage and community cohesion (β = -.03, p = .004), such that higher disadvantage was associated with higher externalizing (but not internalizing) symptomatology at low and medium, but not high, levels of cohesion. We identified similar patterns of results in the rural subsample, and the interaction neared conventional significance thresholds (β = -.09, p = .052). There was no significant interaction with adversity.

Conclusions: Community cohesion may serve as a protective factor for youth experiencing neighborhood disadvantage by mitigating effects on externalizing symptoms.