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Sunday Scaries

To build “healthier cities,” we need to reevaluate urban wellness

Before you move to the suburbs, consider this.

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After World War II, suburban housing developments sprawled across the United States. Advertisements promised gardens and sunshine, a way to “live better,” and a reward for working hard in crowded, dirty cities. Urban areas were for stress. The suburbs were for relaxation.

This posturing of urban spaces as bad for the brain is still reflected in the cultural lexicon and some research. The “Seattle freeze,” for example, is a term reflecting the belief that it’s tough to make friends in the city of Seattle, Washington. Compared to rural areas, the “risk for serious mental illness” is higher in cities, studies have found. One 2018 paper found urban dwellers are 20 percent more likely to develop depression than their counterparts.

However, a new research article published in the journal Proceedings of the National Academy of Sciences suggests the idea that “cities are bad for mental health” is overly simplistic.

This paper takes a statistical, mathematical approach to the issue to argue that cities are actually pretty good. It examines factors like the likelihood of interacting with more people and the simple circumstance that larger groups have a higher chance of revealing more cases of depression. Instead of the common assumption that cities are detrimental to mental health, larger networks can be a buffer against depression.

“... doubling city population is associated with roughly 10 percent reduction in depression rates.”

There is, of course, some necessary nuance here: you can be depressed in the countryside or you can be depressed in a metropolis. There’s no “one size fits all” answer — but that’s the point of the study anyway. First author Andrew Stier, a doctoral student in integrative neuroscience at the University of Chicago, notes it’s essential that what this study describes is a population-level effect.

This aerial shot was taken of a suburban housing development in Long Island, New York in 1950. Frederic Lewis/Getty Images

“Of course, there are individual factors and maybe even neighborhood factors which are important for mental health, but our results suggest that, on average, doubling city population is associated with roughly 10 percent reduction in depression rates,” Stier tells Inverse.

“We are very interested to see if these results extend to other aspects of mental health, such as anxiety or schizophrenia. The relationship between city size and these other aspects of mental health could be different,” he says.

Stier and colleagues looked at datasets reflecting the prevalence of depression in U.S. cities and assessed how race, income, education, and population change influenced depression rates in larger cities. Regardless of all these other factors, the team found it was population change that really mattered, writing that evidence points to “general empirical support for the expectation that larger cities are associated with a decreased risk for depression.”

“Based on size alone, large cities bear the brunt of the social and economic burden of depression disorders,” they write. “Our findings suggest that on a relative basis, however, smaller cities are actually worse off.”

The importance of social networks — While understanding the why would involve research beyond this model, the science suggests it’s the benefits of social interactions that drive this positive effect. Despite the stereotype of feeling lonely in the big city, the greater number of social connections inherent in urban areas may “provide a social buffer against negative affect and depression in the most vulnerable people (those with the smallest social networks),” the scientists write.

Stier explains that it’s not so surprising to find social networks are important in understanding depression, but rather, “what was surprising to us was just how much the layout and size of cities can impact depression rates.”

Urban dwellers in San Francisco, California interact in May 2020. Josh Edelson/AFP via Getty Images

On a personal level, you might recognize the importance of quality social contacts. Is it better to chat with a bunch of strangers throughout the day rather than have a small, close circle?

The answer is likely a bit of both. Research shows high-quality friendships are beneficial for warding off depression, but this model only considers the number of social connections. (“Taking into account the quality of these contacts is something we are very interested in pursuing in the future,” Stier says.)

An urban future —Ultimately, this is less about a debate over city living and more about gathering information to prepare for an inevitable future. The United Nations projects 68 percent of the world will live in urban areas by 2050. It’s essential to spend time now figuring out how beneficial or detrimental they are to mental health and “how we can build better cities that are more pleasant and healthier to live in.”

An aerial photo of lower Manhattan from 2009. Mario Tama/Getty Images

Even if cities correlate with a reduction in depression rates, this, for example, doesn’t negate other research that shows the benefits of growing up around nature. But you also don’t need to live in the countryside to experience this positivity. Urban designers are actively working on creating city spaces that incorporate greenery.

“Our study tells us it is important to think about how cities are different when evaluating their association with and influence on mental health,” Stier says.

“In the past, the focus has been largely on the wholesale difference between rural areas and urban areas, and that has obscured some of the nuanced understanding we need to fully understand how cities impact mental health and figure out how to build healthier cities.”

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