Taken together, epidemiological and neuroscientific studies provide converging evidence that, indeed, people who live in urban areas are at greater risk of mental health problems. So which specific factors within the urban environment increase the risk of developing such problems?
Epidemiological studies have identified a large number of factors. Some of these highlight potential problems in the built environment, such as reduced access to green spaces and high levels of noise and air pollution. Others pertain to the social environment, such as loneliness, perceived and actual crime, and social inequalities.
These studies were based on the collection of a single snapshot per participant, and therefore could not capture the multiple and diverse environments that most people experience throughout the day. But some new studies are using smartphone technologies to collect multiple measurements as people go about their daily life. Urban Mind, for example, is a citizen-science project which uses a smartphone app to measure the experience of urban or rural living in real-time.
It’s important to recognise that those factors within the urban environment which increase the risk of mental illness are neither intrinsic nor inevitable aspects of urban living. Instead they are the result of poor planning, design and management, and could be reversed. Which takes us to the next question: could urban living be good for our mental health?
The bright side
While existing research focuses on the negative impacts of urban living on mental health, framing the accelerated urbanisation taking place worldwide as a challenge to humankind, this is an oversimplification of what it means to live in a city for at least three reasons.
First, urban living is a complex, contradictory and difficult to define phenomenon, with little in common between the resident of a deprived suburb and that of a garden city; or between the processes of gentrification and those of inner city decline. Consistent with this notion, the incidence of depression within urban areas is lower when people have access to high quality housing and green spaces.
Second, we know that all health, and mental health in particular, depends on both nature and nurture. For example, emerging evidence from epigenetics, which examines how the environment affects the expression of our genes, suggests that the impact of urban living depends on our preexisting genetic makeup.
Third, for many people, urban living can bring great benefits to mental health through increased opportunities for education, employment, socialisation and access to specialised care. Moving to a city can be the first step towards the realisation of one’s full potential, and a necessary condition to gain access to communities with similar interests and values.
Ultimately, cities offer a swath of obstacles and opportunities, freedom and captivity, which can challenge as well as nurture us, often at the same time.