Ylbert Durishti / Flickr

A new study finds a link between bus or rail access and fewer antidepressants in older residents of Turin, Italy.

To call the city a stressful place is to undersell the ceaseless assault waged on your sanity by the urban environment. That persistent strain can take the form of something as simple as traffic delays that chip away at your patience to something as complex as an increased risk for schizophrenia. City intensity is so potentially distressing that, over time, humans brains have adapted by filtering out the lesser annoyances that aren’t quite worth a worry.

Of course, it’s not all bad downtown. There might be a Shake Shack nearby, or at least the hope of one to come. Urban trees and parks have a profoundly beneficial impact on our attention spans and general mental health. And a new study suggests two other regular elements of city life that might do the mind some good as well, particularly for older populations: access to public transportation, and dense surroundings.

Here’s the upshot, via the International Journal of Environmental Research and Public Health:

Therefore, this research suggests that good accessibility to public transport, as well as a dense urban structure (versus sprawl), could contribute to reduced risk of depression, especially for women and elderly, by increasing opportunities to move around and have an active social life.

For the study, a group of Italy-based researchers gathered long-term data on Turin residents. In addition to basic demographics (such as education and job status) and social factors (such as crime rates), they looked at five characteristics of the local built environment: developmental density, land use mixture, public and green space, cultural facilities, and transit access. They also gathered information on antidepressant prescriptions, as a measure of mental health.

Of the environmental factors, density and transit access proved “protective” of mental health, especially for women (of all ages) and older people (age 50 to 64). These populations were prescribed fewer antidepressant drugs when they lived in places reached more quickly by bus or train, in places with taller average building heights, compared with counterparts in more remote or sparse areas. That connection held up even when social factors were taken into account.

This type of large-scale data analysis can’t pinpoint causal mechanisms. But it’s not hard to speculate why transit and density might reduce stress: the former relieves the need to drive everywhere; the latter enhances the potential for social connectivity. For older populations, in particular, both aspects of a city inoculate them against feelings of isolation or loneliness. They also stand in contrast to remote suburban living that “can have a serious impact on mental health, particularly when it results in forgone trips,” the researchers write.

The study failed to find any connection between mental health and public green space. That’s surprising considering the vast evidence supporting this link. But the researchers suspect that some of the benefits of urban parks were embedded in the density and accessibility traits that did show ties to reduced antidepressant use. In other words, these factors may be mashed together in ways that discrete statistics can’t easily capture.

Other drawbacks to the work merit a mention. Antidepressant prescriptions are an imprecise proxy for mental health. The demographic variables didn’t include income, which is a powerful health indicator. And prior work has reached conflicting conclusions; a 2013 study of Boston youths, for instance, found that higher subway stop density actually predicted an increase in depressive symptoms among some racial groups.

So there’s still a lot to understand about the key stressors—and stress-relievers—of city life. But it’s hard to see the study’s conclusion as anything but sound advice regardless of where the science eventually lands:

In order to address health inequalities, urban policies should invest in the delivery of services that enhance resilience factors, above all a good public transport network, in a careful and equal manner, throughout the city.

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