Impact of housing price increases on depression and stress in urban Iran: a case study from district 18 of Tehran

BACKGROUND: Unaffordable housing has become a critical public health concern in developing countries, where rapid urbanization and inequality increase mental health risk. While existing research has explored economic and infrastructural dimensions of housing, limited attention has been given to how rising housing prices impact psychological well-being in low-income urban neighborhood. This study investigates the relationship between housing price increases and two key mental health outcomes depression and perceived stress within District 18 of Tehran, Iran. METHODS: A cross-sectional study was conducted among 180 households across seven neighborhoods in District 18, using standardized psychometric tools: the Perceived Stress Scale (PSS-14) and Beck Depression Inventory-II (BDI-II). Housing indicators, including apartment and villa prices, household density, and building density, were obtained from municipal datasets. Spatial clustering and regression analyses were applied to examine the spatial and statistical relationships between housing and mental health patterns. RESULTS: Housing price increases showed a strong positive correlation with both depression and perceived stress. The regression model revealed that apartment and villa prices accounted for 64.9% of the variation in depression scores (p < 0.001). Building density (34.8%) and household density (20.5%) were also significant predictors of psychological distress. Spatial analysis identified clustered hot spots of high depression and stress levels, particularly in high-density, high-price neighborhoods. The Moran's I index confirmed significant spatial autocorrelation for building density (I = 0.348, p = 0.041). CONCLUSIONS: This study highlights the significant impact of housing market pressures on mental health in underprivileged urban districts. The results suggest that rising housing prices and overcrowding have significantly increased the psychological burden among residents, emphasizing the need for integrative urban planning and mental health interventions.