Stress and the City: Mental Health in Urbanized vs. Rural Areas in Salzburg, Austria.

Background: Living in the city is associated with a higher risk of suffering from stress, anxiety, and depression. Due to an increase of migration to the city, the association between mental health and city life is highly relevant to society.

Methods: We analyzed data of 9573 participants (Ø 55.3 years, SD = 7.4) of the Paracelsus 10,000 study (Salzburg, Austria) who were classified into having or not having depressive symptoms. Population density, green space, and noise around the home address of the participants were collected and tested for correlations with mental health defined by depressive symptoms. We additionally tested whether migration status influenced the effect of urbanization on mental health.

Results: There is a positive correlation between degree of urbanization and the probability of suffering from depressive symptoms (p = 0.011), yet this effect is independent of the migration background (p = 0.581). Participants in areas with high residential density were significantly more likely to suffer from poor mental health (p = 0.006 unadjusted). No significant association could be found between mental health and noise (p = 0.126 unadjusted) or green space neither regarding distance to closest green space (p = 0.549 unadjusted), nor size of green space (p = 0.549 unadjusted).

Conclusions: In the Paracelsus 10,000 cohort, living in the city is associated with lower mental health, especially in participants with a high population density in the direct neighborhood. This might be due to social stress yet does not reflect minority stress in migrants. However, the influence of noise pollution and green space on mental health is limited in this cohort.