The psychological aspects of an individual’s experience, such as thoughts, emotions and behaviour, are shaped by her interaction with her environment, that is, are inherently psychosocial in nature (Ray, 2006). Psychosocial wellbeing and mental health have intrinsic value, and there is also increasing evidence that they can affect people’s behaviour and resulting economic outcomes (Lybbert & Wydick, 2017). The physical and social characteristics of the place where a person conducts her life have a potentially important influence on her psychosocial wellbeing, especially in countries characterized by high spatial inequality, that is, by high levels of disparities in opportunities and in human, social and economic development, as is the case of Latin America in general, and of Mexico in particular (Modrego & Berdegué, 2015).

Psychosocial problems affect a significant portion of the Mexican population, but access to treatment is limited and spatially concentrated (Instituto Nacional de Psiquiatría, 2010). The treatment gap for major depression (that is, the difference between the share of people suffering from major depression and the share of people treated for it) in rural Mexico was higher than the world median (Kohn et al., 2004). A better understanding of the relationship between place characteristics and psychosocial wellbeing can provide useful information to improve the design and effectiveness of local development policies that may also improve psychosocial wellbeing, thereby complementing public health policies for addressing the treatment gap.

The literature on the determinants of psychosocial wellbeing has focused mostly on the United States. We know less about the contextual determinants of psychosocial wellbeing in low- and middle-income countries. In a recent article, we provide new findings on the relationship between the psychosocial wellbeing of working age Mexicans and the characteristics of the place they live. We explore psychosocial wellbeing in terms of depression symptoms, self-reported feelings of sadness and experience of stress. We examine the average relationship between place characteristics and psychosocial wellbeing, as well as the moderating effect of gender, age, individual wealth, and employment status.

Our results suggest that, overall, place characteristics are significantly associated with psychosocial wellbeing, but seem to play a more important role in the experience of stress than in depression symptoms. However, not all the place characteristics we examine are important for psychosocial wellbeing, and we also find evidence of heterogeneity in how they affect the psychosocial wellbeing of different groups. Two broad sets of results emerge.

First, place characteristics that contribute to defining the local structure of opportunities and constraints appear to affect the wellbeing of all groups, albeit in a different way depending on individual characteristics. Living in a place that lacks economic opportunities and where extreme poverty is high is harmful to the psychosocial wellbeing of all socio-demographic groups analysed, but groups differ among them in the specific aspect of psychosocial wellbeing which is affected. Living in a place where extreme poverty is high increases stress among poorer people, and depression among both wealthier individuals and unemployed people. Meanwhile, a lack of local economic opportunities, as indicated by unemployment and closing-down of local firms, increases depression among women and older individuals, and stress among men.

Second, place characteristics that relate with social connections and the presence of a network of support appear to be more important for more vulnerable groups, especially women and poorer people. On the one hand, living in a violent context harms the psychosocial wellbeing of women and older people, but does not significantly change the wellbeing of men and younger individuals. On the other, a more tightly knit social environment, as indicated by the presence of community activities, has a protective effect on the psychosocial wellbeing of women and poorer people, and availability of public goods and services improves the psychosocial wellbeing of older people.

Our results suggest that local development policies focused on employment creation and poverty reduction, and which also facilitate the strengthening of social ties, can improve not only the material conditions of the local population, but also their psychosocial wellbeing. The evaluation of costs and benefits of poverty-reduction policies, and of territorial development programs in high unemployment and low-income areas, should take this into account, and these policies should be valued not just in terms of their economic impacts, but also as interventions that can improve individual psychosocial wellbeing and mental health. This is particularly important for Mexico, where the spatial distribution of mental healthcare is unequal and treatment gaps are wide. Public health policies and territorial development policies should in fact be considered as complementary tools for the improvement of local psychosocial wellbeing. Future research should focus on establishing causal links between place characteristics and individual psychosocial wellbeing, and on identifying mechanisms that explain variations among sub-groups.

Further reading:

Cazzuffi, C., and López Moreno, D., (2018) “Psychosocial wellbeing and place characteristics in Mexico”. Health & Place, 50(C), 52-64. DOI: https://doi.org/10.1016/j.healthplace.2018.01.002

References:

Instituto Nacional de Psiquiatría (2010). Indicadores básicos de los servicios de salud mental en México. Mexico City, Mexico.

Kohn, R., Saxena, S., Levav, I., & Saraceno, B. (2004). "The treatment gap in mental health care." Bulletin of the World Health Organization 82(11):858-866.

Lybbert, T., Wydick, B. (2017). "Poverty, Aspirations, and the Economics of Hope," forthcoming, Economic Development and Cultural Change. DOI: https://doi.org/10.1086/696968

Modrego, F., Berdegué, J. (2015). A Large-Scale Mapping of Territorial Development Dynamics in Latin America. World Development 73: 11-31

Ray, D. (2006). Aspirations, Poverty and Economic Change. In Banerjee, A., Bénabou, R., Mookherjee, D. (eds). "Understanding Poverty". Oxford University Press. https://www.nyu.edu/econ/user/debraj/Courses/Readings/povasp01.pdf