Investigating whether area-level social fragmentation is cross-sectionally associated with adolescent depression and anxiety in a Canadian context

BACKGROUND: This research examined whether area-level social fragmentation was associated with adolescent depressive and anxiety symptoms, and whether heterogeneity by gender was present. METHODS: Cross-sectional adolescent data (n = 66, 434) from wave 6 (2017-18) of the COMPASS study were used. Demographic information, depression, and anxiety were reported via questionnaire. Census division social fragmentation was derived from four census variables (proportions of renters, movers in last year, single tenant households, and unmarried couples). Multilevel linear regression analyses were performed to account for students nested within schools (n = 122), who were nested within census divisions (n = 40) while accounting for province, student, and census division characteristics. Interaction terms were added to adjusted models to examine heterogeneity by gender. RESULTS: In adjusted models, a one standard deviation increase in social fragmentation was associated with higher depressive symptoms (β = 0.39, 95% CI: 0.04, 0.75) and anxiety symptoms (β = 0.39, 95% CI: 0.03, 0.75). Findings became non-significant in models with province as fixed effect. The slopes were lower for females (depression: β = -0.18, 95% CI: -0.28, -0.09; anxiety: β = -0.26, 95% CI: -0.36, -0.16) than for males. CONCLUSION: Social fragmentation may be a contextual risk factor for adolescent depression and anxiety; however, more research is needed investigating social fragmentation at multiple scales and over time. Understanding potential mechanisms for differences between males and females is also needed.