ABSTRACT
OBJECTIVE: To explore relationships between disability, food insecurity (FI) and age and examine how socio-economic factors impact risk of FI among disabled people in working and older age. DESIGN: Logistic regression models used to analyse the contribution of socio-economic factors to gaps in risk of FI for disabled people. In models stratified into working and older age groups, differences in risk of FI for disabled and non-disabled people were examined by employment, education and assets. SETTING: England, Wales and Northern Ireland, 2016 and 2018. PARTICIPANTS: A representative sample of 6187 adults aged 16+, of whom 28 % were disabled, from the Food & You survey. RESULTS: The gap in FI risk by disability status decreased as age increased. For ages 25-34 for disabled v. non-disabled people, risk of FI was 31 % (95 % CI 21-41 %) v. 10 % (8-12 %); at ages 45 to 54, it was 18 % (11-23 %) v. 7 % (5-8 %), and at ages 75+, there was no gap in risk. Accounting for socio-economic variables halved the gap in risk among working ages. However, among working-age adults, FI among disabled people in full-time work was 15 % (11-20 %) compared with only 7 % (6-9 %) among non-disabled people in full-time work. Among older people, disabled people without savings were at higher risk of FI (5 % (3-7 %)) than non-disabled people without savings (2 % (1-3 %)) but having savings closed risk gap. CONCLUSIONS: Socio-economic resources partially explain disparities in FI risk when disabled. Disparities remained for people in full-time work and among people without savings in older age.
Subject(s)
Food Insecurity , Food Supply , Humans , Aged , Income , Employment , Educational StatusABSTRACT
OBJECTIVE: To estimate the impact of the UK nationwide campaign to End loneliness on loneliness and mental health outcomes among older people in England. DESIGN: Quasi-experimental design, namely, a difference-in-differences approach. SETTING: Local authorities across England. PARTICIPANTS: Older adults aged 65 and over participating in waves 4-8 (2008-2017) of the English Longitudinal Study of Aging (ELSA) and waves 1-9 (2009-2019) of the UK Household Longitudinal Study (UKHLS). MAIN OUTCOME MEASURES: Loneliness was measured through the UCLA Loneliness scale. A social isolation scale with components of household composition, social contact and participation was constructed. Mental health was measured by The Centre for Epidemiological Studies of Depression (CES-D) score, the General Health Questionnaire (GHQ-12) score, and the Short-Form-12 Mental Component Summary (SF-12 MCS) score. RESULTS: There was no evidence of change in loneliness scores over the study period. Difference-in-differences estimates suggest that explicitly developed and implemented antiloneliness strategies led to no change in loneliness scores (estimateâ¯=â¯0.044, SEâ¯=â¯0.085), social isolation caseness (estimateâ¯=â¯0.038, SEâ¯=â¯0.020) or levels of depressive symptoms (estimateâ¯=â¯0.130, SEâ¯=â¯0.165). Heterogeneity analyses indicate that antiloneliness strategies produced little impact on loneliness or mental health overall, despite small reductions in loneliness and increases in social engagement among well-educated and higher-income older adults. The results were robust to various sensitivity and robustness analyses. CONCLUSIONS: Antiloneliness strategies implemented by local authorities have not generated a significant change in loneliness or mental health in older adults in England. Generating changes in loneliness in the older population might require longer periods of exposure, larger scope of intervention or more targeted strategies.
Subject(s)
Loneliness , Mental Health , Humans , Aged , Loneliness/psychology , Longitudinal Studies , Social Isolation/psychology , United KingdomABSTRACT
BACKGROUND: Neighborhood deprivation and depression have been linked to epigenetic age acceleration. The next-generation epigenetic clocks including the DNA methylation (DNAm) GrimAge, and PhenoAge have incorporated clinical biomarkers of physiological dysregulation by selecting cytosine-phosphate-guanine sites that are associated with risk factors for disease, and have shown improved accuracy in predicting morbidity and time-to-mortality compared to the first-generation clocks. The aim of this study is to examine the association between neighborhood deprivation and DNAm GrimAge and PhenoAge acceleration in adults, and assess interaction with depressive symptoms. METHODS: The Canadian Longitudinal Study on Aging recruited 51â 338 participants aged 45-85 years across provinces in Canada. This cross-sectional analysis is based on a subsample of 1 445 participants at baseline (2011-2015) for whom epigenetic data were available. Epigenetic age acceleration (years) was assessed using the DNAm GrimAge and PhenoAge, and measured as residuals from regression of the biological age on chronological age. RESULTS: A greater neighborhood material and/or social deprivation compared to lower deprivation (bâ =â 0.66; 95% confidence interval [CI]â =â 0.21, 1.12) and depressive symptoms scores (bâ =â 0.07; 95% CIâ =â 0.01, 0.13) were associated with higher DNAm GrimAge acceleration. The regression estimates for these associations were higher but not statistically significant when epigenetic age acceleration was estimated using DNAm PhenoAge. There was no evidence of a statistical interaction between neighborhood deprivation and depressive symptoms. CONCLUSIONS: Depressive symptoms and neighborhood deprivation are independently associated with premature biological aging. Policies that improve neighborhood environments and address depression in older age may contribute to healthy aging among older adults living in predominantly urban areas.
Subject(s)
Aging, Premature , Depression , Humans , Aged , Depression/epidemiology , Depression/genetics , Cross-Sectional Studies , Longitudinal Studies , Canada/epidemiology , Aging/genetics , Acceleration , DNA Methylation , Epigenesis, GeneticABSTRACT
AIMS: Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live. This article introduces the 'Improving Adolescent mentaL health by reducing the Impact of poVErty (ALIVE)' study, its conceptual framework, objectives, methods and expected outcomes. The aim of the ALIVE study is to develop and pilot-test an intervention that combines poverty reduction with strengthening self-regulation to prevent depression and anxiety among adolescents living in urban poverty in Colombia, Nepal and South Africa. METHODS: This aim will be achieved by addressing four objectives: (1) develop a conceptual framework that identifies the causal mechanisms linking poverty, self-regulation and depression and anxiety; (2) develop a multi-component selective prevention intervention targeting self-regulation and poverty among adolescents at high risk of developing depression or anxiety; (3) adapt and validate instruments to measure incidence of depression and anxiety, mediators and implementation parameters of the prevention intervention; and (4) undertake a four-arm pilot cluster randomised controlled trial to assess the feasibility, acceptability and cost of the selective prevention intervention in the three study sites. RESULTS: The contributions of this study include the active engagement and participation of adolescents in the research process; a focus on the causal mechanisms of the intervention; building an evidence base for prevention interventions in LMICs; and the use of an interdisciplinary approach. CONCLUSIONS: By developing and evaluating an intervention that addresses multidimensional poverty and self-regulation, ALIVE can make contributions to evidence on the integration of mental health into broader development policy and practice.
Subject(s)
Depression , Self-Control , Adolescent , Humans , Anxiety/prevention & control , Anxiety/psychology , Colombia/epidemiology , Depression/psychology , Interdisciplinary Research , Nepal , Poverty , South Africa/epidemiologyABSTRACT
Background: Colombia has endured more than five decades of internal armed conflict, which led to substantial costs for human capital and mental health. There is currently little evidence about the impact of incorporating a mental health intervention within an existing public cash transfer program to address poverty, and this project aims to develop and pilot a mental health support intervention embedded within the human capital program to achieve better outcomes among beneficiaries, especially those displaced by conflict and the most socioeconomically vulnerable. Methods: The study will consist of three phases: semi-structured one-to-one interviews, co-design and adaptations of the proposed intervention with participants and pilot of the digital intervention based on cognitive behavioral therapy and transdiagnostic techniques to determine its feasibility, acceptability, efficacy, and usefulness in 'real settings'. Results will inform if the intervention improves clinical, educational and employment prospects among those who use it. Results: Knowledge will be generated on whether the mental health intervention could potentially improve young people's mental health and human capital in conflict-affected areas? We will evaluate of the impact of potential mental health improvements on human capital outcomes, including educational and employment outcomes. Conclusion: Findings will help to make conclusions about the feasibility and acceptability of the intervention, and it will assess its effectiveness to improve the mental health and human capital outcomes of beneficiaries. This will enable the identification of strategies to address mental health problems among socioeconomically vulnerable young people that can be adapted to different contexts in in low and middle-income countries.
ABSTRACT
Urbanization is generally believed to contribute to dietary patterns that increase the risk of non-communicable disease (NCD). However, empirical evidence using nuanced measures of urbanization and longitudinal data is limited. This study examines the link between urbanization and dietary patterns in Indonesia, the largest country in Southeast Asia, between 2000 and 2015. Results show that urbanisation is associated with dietary patterns conducive to increased NCD risk-for example, high in soft drinks and ultra-processed foods-but also with higher consumption of healthier foods such as vegetables and fish. Results highlight important non-linearities and draw attention to the need to refrain from generalizations about the effect of urbanization on nutritional health.
Subject(s)
Noncommunicable Diseases , Urbanization , Humans , Indonesia , Diet , VegetablesABSTRACT
BACKGROUND: Interventions that combine cognitive behavioral therapy (CBT) with unconditional cash transfers (UCT) reduce the risk of antisocial behavior (ASB), but the underlying mechanisms are unclear. In this paper, we test the role of psychological and cognitive mechanisms in explaining this effect. We assessed the mediating role of executive function, self-control, and time preferences. METHODS: We used data from the Sustainable Transformation of Youth in Liberia, a community-based randomized controlled trial of criminally engaged men. The men were randomized into: Group-1: control (n = 237); and Group-2: CBT+UCT (n = 207). ASB was measured 12-13 months after the interventions were completed, and the following mediators were assessed 2-5 weeks later: (i) self-control, (ii) time preferences and (iii) executive functions. We estimated the natural direct effect (NDE) and the natural indirect effect (NIE) of the intervention over ASB. RESULTS: Self-control, time preferences and a weighted index of all three mediators were associated with ASB scores, but the intervention influenced time preferences only [B = 0.09 95%CI (0.03; 0.15)]. There was no evidence that the effect of the intervention on ASB was mediated by self-control [BNIE = 0.007 95%CI (-0.01; 0.02)], time preferences [BNIE = -0.02 95%CI (-0.05; 0.01)], executive functions [BNIE = 0.002 95%CI (-0.002; 0.006)] or the weighted index of the mediators [BNIE = -0.0005 95%CI (-0.03; 0.02)]. CONCLUSIONS: UCT and CBT lead to improvements in ASB, even in the absence of mediation via psychological and cognitive functions. Findings suggest that the causal mechanisms may involve non-psychological pathways.
Subject(s)
Antisocial Personality Disorder , Cognitive Behavioral Therapy , Male , Adolescent , Humans , Antisocial Personality Disorder/prevention & control , Liberia , Mediation Analysis , CausalityABSTRACT
Studies suggest that welfare-to-work programmes increase lone mother's employment, but their impact on child and adolescent socioemotional development is unclear. The lone parent obligation (LPO) reform introduced a requirement for lone mothers entitled to unconditional Income Support (IS) to seek paid work actively as a condition to receive benefits. We use data from the UK Millennium Cohort Study to examine the impact of work search requirements for lone parents on child and adolescent socioemotional development. We apply a difference-in-differences approach that exploits gradual changes from 2008 to 2017 in children's maximum eligibility age to receive IS and assess effects on child and adolescent Strengths and Difficulties Questionnaire (SDQ) scores. We find that the LPO reform led to a ten-percentage point increase in lone mothers' employment but no change in the risk of family poverty. The reform led to a small but statistically significant increase in adolescents' SDQ scores, which indicated worse mental health and was largely driven by increased emotional problems. It also led to an increase in mothers' distress and poor self-rated health, and mothers' reports that time spent with children was insufficient. Our findings highlight the need to consider trade-offs between employment gains and child and adolescent socioemotional development in assessing the net impact of welfare-to-work policies targeting lone parents.
Subject(s)
Employment , Parents , Child , Female , Adolescent , Humans , Cohort Studies , Employment/psychology , Mothers/psychology , United KingdomABSTRACT
Food insecurity affects 14% of US homes with children and has been associated with increased mental health problems. Few studies have examined long-term consequences for mental health and the role of social policies. This study examined the association between childhood household food insecurity (HHFI) and young adult psychological distress, and the moderating role of caregiver psychological distress and the Supplemental Nutrition Assistance Program (SNAP) using data from the Panel Study of Income Dynamics (1995-2015). The sample comprised 2782 children ages 0-12 years in 1997. Past-year HHFI was measured using the USDA 18-item questionnaire in 1997, 1999, 2001 and 2003. Young adults' non-specific psychological distress was measured with the Kessler (K6) scale in 2005, 2007, 2009, 2011, 2013 and 2015. Three trajectories of food insecurity were identified: 1) Persistent food security (70.5%); 2) Intermediate/fluctuating food insecurity (24.6%), and; 3) Persistent food insecurity (4.9%). Compared to persistent food security, fluctuating and persistent food insecurity were associated with significantly higher levels of psychological distress. This association was robust to adjusting for socio-demographic factors, caregiver psychological distress, and family access to governmental supports: [Adj. ORs (95% CI's = 1.72 (1.59-1.85) and 2.06 (1.81-2.33)]. Having a caregiver who suffered from psychological distress (1997 and/or 2002) and growing up with persistent food insecurity placed children at greater risk for mental health problems. Access to SNAP attenuated this risk. Early HHFI is associated with psychological distress in young adulthood. Interventions to increase access to SNAP and address caregivers mental health may prevent mental health problems associated with childhood HHFI.
Subject(s)
Food Assistance , Young Adult , Humans , Child , Adult , Infant, Newborn , Infant , Child, Preschool , Poverty , Food Supply , Income , Food InsecurityABSTRACT
â¢Transitioning to grandmotherhood was associated with a higher probability of reporting ≥1 functional limitations in ADLs.â¢Transitioning to grandparenthood was associated with higher life satisfaction.â¢Role enhancement and role strain may generate mixed impacts of transitioning to grandparenthood on older adults' health.
ABSTRACT
In this commentary, invited for the 100th anniversary of the Journal, we discuss the addition of randomized experiments, along with natural experiments that emulate randomized trials using observational data, as designs in the social epidemiologist's toolbox. These approaches transform the way we define and ask questions about social exposures. They compel us to ask questions about how well-defined interventions change a social exposure that might lead to changes in health. As such, experiments are of unique public health and policy significance. We argue that they are a powerful approach to advance our understanding of how well-defined changes in social exposures impact health, and how credible social policy reforms may be instrumental to address health inequalities. We focus on two research designs. The first is a "pure" randomized controlled trial (RCT) in which the investigator defines and randomly assigns the intervention. The second is a natural experiment, which exploits the fact that policies or interventions in the real world often involve an element of random assignment, emulating an RCT. To give the reader our bottom line: While acknowledging their limits, we continue to be very excited about the promise of RCTs and natural experiments to advance social epidemiology.
Subject(s)
Public Health , Social Determinants of Health , Humans , PolicyABSTRACT
Extensive research suggests that poverty is associated with adolescent mental health problems. However, studies typically focus on monetary poverty and have not examined how other dimensions of poverty relate to adolescent mental health. This study examines the association between multidimensional poverty and mental health among adolescents using a Multidimensional Poverty Index. Based on data from the National Mental Health Survey in Colombia, we show that adolescents living in multidimensionally poor households have 50% higher risk of having mental health problems compared to adolescents in non-poor households. We unpack and assess the relation between each of the dimensions of poverty and mental health, and whether deprivations directly experienced by the adolescent are more strongly associated with mental health problems than deprivations experienced by other household members. Individual deprivations associated with human capital linked to schooling, work, health insurance and employment are more strongly associated with adolescent mental health problems than material deprivations. Lagging behind in school and working while studying has the strongest association with adolescent mental health problems. Results suggest that public policies that address dimensions of poverty associated with adolescents human capital accumulation may be critical to address mental health problems among adolescents.
ABSTRACT
Studies in Western countries suggest that receiving informal care from family members may reduce utilisation of health care services. This hypothesis has not been examined in China, where the population is ageing rapidly. We assess the impact of informal care from offspring (children and grandchildren) on health care utilisation and expenditures among older people in China. Data are drawn from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Using lagged model with the instrumental variable approach, we find that the impact of informal care is different by type of health care: More hours of informal care from offspring reduces overall health care utilisation, and in particular, outpatient care utilisation, but it increases inpatient care utilisation and expenditures. Our results suggest that informal care reduces the demand for outpatient care but increases the demand for inpatient care, possible reflecting the fact that the latter involves more advanced procedures for which informal care is not a substitute but a complement. Results highlight the need for incorporating health care impacts in the analysis and evaluation of policies that affect informal care provision.
Subject(s)
Ambulatory Care , Family , Aged , Child , China , Health Expenditures , Humans , Patient Acceptance of Health CareABSTRACT
BACKGROUND: The relationship between disability and food insecurity is under-researched. Risk of food insecurity may vary by type and number of disabilities. We examine the hypotheses that (i) a higher number of disabilities increases risk of food insecurity and (ii) associations of physical disabilities, mental/cognitive disabilities or a combination of both types with food insecurity may differ in strength. METHODS: Data came from the fifth wave of the UK's Food Standards Agency's Food and You survey (2018), which contains detailed information on disability and household food insecurity. We used logistic and multinomial logistic regression to model the number and type of disabilities as predictors for food insecurity outcomes, controlling for socio-demographic factors. RESULTS: Both type and number of disabilities predicted food insecurity. Every additional disability was associated with higher odds of food insecurity [odds ratio (OR): 1.60, 95% confidence interval (CI): 1.40-1.83]. Among people with a disability, every additional disability was associated with 19% higher odds of food insecurity (OR: 1.19, 95% CI: 1.05-1.34). People with both physical and mental/cognitive disabilities had increased odds of severe food insecurity (OR: 8.97, 95% CI: 3.54-22.7). CONCLUSION: Number and type of disabilities are associated with higher risk of food insecurity. A combination of physical and mental/cognitive disabilities, as well as having multiple disabilities are each independently associated with higher risk of food insecurity. Policy-makers may thus consider using targeted and tailored policies to reduce barriers to social and financial inclusion of disabled people to reduce food insecurity.
Subject(s)
Disabled Persons , Food Supply , Adult , Food Insecurity , Humans , Surveys and QuestionnairesABSTRACT
BACKGROUND: Young people living in poverty are at higher risk of mental disorders, but whether interventions aimed to reduce poverty have lasting effects on mental health has not been well established. We examined whether exposure to Brazil's conditional cash transfers programme (CCT), Bolsa Família (BFP), during childhood reduces the risk of mental health problems in early adolescence. METHODS: We used data from 2063 participants in the 2004 Pelotas Birth Cohort study. Propensity score matching (PSM) estimated the association between BFP participation at age 6 and externalising problems (Strengths and Difficulties Questionnaire - SDQ and violent behaviour) and socio-emotional competencies (Development and Well-Being Assessment questionnaire, and the Nowick-Strickland Internal-External Scale) at age 11. RESULTS: PSM results suggest that programme participation at age of six was not significantly associated with externalising problems (P = 0.433), prosocial behaviour (P = 0.654), violent behaviour (P = 0.342), social aptitudes (P = 0.281), positive attributes (P = 0.439), or locus of control (P = 0.148) at the age of 11 years. CONCLUSIONS: Participation in BFP during childhood was not associated with improved or worsened mental health in early adolescence. While we cannot fully discard that findings may be due to adverse selection, results suggest that CCTs alone may not be sufficient to improve mental health outcomes and would be prudent to assess whether mental health interventions as an addition to CCTs may be helpful.
Subject(s)
Mental Health , Poverty , Adolescent , Adolescent Health , Brazil , Child , Cohort Studies , HumansABSTRACT
OBJECTIVES: This report aims to examine income-related inequalities in informal care among older people with functional limitations in China. METHODS: Data are drawn from the 2005, 2008, 2011, and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Erreygers concentration index, concentration index, and horizontal inequity index are used to examine inequalities in informal care. A random effects model is then used to investigate the relationship between household income and informal care. RESULTS: There is no significant association between household income and the probability of receiving informal care. However, we observed a significant positive association between household income and hours of informal care received, indicating that those with higher household income receive more hours of informal care compared to those with lower household income. The degree of this inequality increases as the number of functional limitations increases. DISCUSSION: Lower household income is associated with lower intensity of informal care received, particularly for older people with more functional limitations. Policies are required to support low-income older people with more functional limitations.
Subject(s)
Aging , Caregivers/statistics & numerical data , Disabled Persons/psychology , Functional Status , Patient Care/statistics & numerical data , Socioeconomic Factors , Aged , Aged, 80 and over , China , Female , Humans , Income/statistics & numerical data , Longevity , Longitudinal Studies , Male , Time FactorsABSTRACT
Social protection measures can play an important part in securing livelihoods and in mitigating short-term and long-term economic, social, and mental health impacts of the COVID-19 pandemic. In particular, cash transfer programmes are currently being adapted or expanded in various low-income and middle-income countries to support individuals and families during the pandemic. We argue that the current crisis offers an opportunity for these programmes to focus on susceptible young people (aged 15-24 years), including those with mental health conditions. Young people living in poverty and with mental health problems are at particular risk of experiencing adverse health, wellbeing, and employment outcomes with long-term consequences. They are also at risk of developing mental health conditions during this pandemic. To support this population, cash transfer programmes should not only address urgent needs around food security and survival but expand their focus to address longer-term mental health impacts of pandemics and economic crises. Such an approach could help support young people's future life chances and break the vicious cycle between mental illness and poverty that spirals many young people into both socioeconomic and mental health disadvantage.
Subject(s)
COVID-19/psychology , Mental Disorders/prevention & control , Mental Health , Public Policy , Adolescent , Developing Countries , Government Programs , Humans , Mental Disorders/economics , Poverty , Public Assistance/economics , Young AdultABSTRACT
BACKGROUND: Studies on associations between urban green space and mental health have yielded mixed results. This study examines associations of green space exposures with subjective health and depressed affect of middle-aged and older adults in four European cohorts. METHODS: Data came from four Western-European and Central-European ageing cohorts harmonised as part of the Mindmap project, comprising 16 189 adults with an average age of 50-71 years. Green space exposure was based on the distance to the nearest green space and the amount of green space within 800 m buffers around residential addresses. Cohort-specific and one-step individual participant data (IPD) meta-analyses were used to examine associations of green space exposures with subjective health and depressed affect. RESULTS: The amount of green spaces within 800 m buffers was lowest for Residential Environment and CORonary heart Disease (Paris, 15.0 hectares) and highest for Health, Alcohol and Psychosocial factors In Eastern Europe (Czech Republic, 35.9 hectares). IPD analyses indicated no evidence of an association between the distance to the nearest green space and depressed affect (OR 0.98, 95% CI 0.96 to 1.00) or good self-rated health (OR 1.01, 95% CI 0.99 to 1.02). Likewise, the amount of green space within 800 m buffers did not predict depressed affect (OR 0.98, 95% CI 0.96 to 1.00) or good self-rated health (OR 1.01, 95% CI 0.99 to 1.02). Findings were consistent across all cohorts. CONCLUSIONS: Data from four European ageing cohorts provide no support for the hypothesis that green space exposure is associated with subjective health or depressed affect. While longitudinal evidence is required, these findings suggest that green space may be less important for older urban residents.
Subject(s)
Diagnostic Self Evaluation , Parks, Recreational , Aged , Cohort Studies , Environment , Humans , Mental Health , Middle AgedABSTRACT
BACKGROUND: This study examines the impact of environmental noise policy on depressive symptoms by exploiting the national experiment afforded by the New Deal aircraft noise control policy introduced in Schiphol (Amsterdam) in 2008. METHODS: Data came from older adults (ages 57-102) participating in three waves (2005/2006, 2008/2009 and 2011/2012) of the Longitudinal Aging Study Amsterdam (LASA) (N=1746). Aircraft noise data from the Netherlands Environmental Assessment Agency were linked to LASA cohort addresses using the GeoDMS software. The Centre for Epidemiologic Studies-Depression (CES-D) scale was used to measure depressive symptoms. Using a difference-in-dfferences (DiD) approach, we compared changes in CES-D levels of depressive symptoms before and after the policy between people living close (≤15 km) and those living far away (>15 km) from Schiphol airport. RESULTS: There were few changes in noise levels after the introduction of the policy. Estimates suggested that the policy did not lead to a reduction in noise levels in the treatment areas relative to the control areas (DiD estimate=0.916 dB(A), SE=0.345), and it had no significant impact on levels of depressive symptoms (DiD estimate=0.044, SE=0.704). Results were robust to applying different distance thresholds. CONCLUSION: The New Deal aircraft noise control policy introduced in Amsterdam was not effective in reducing aircraft noise levels and had no impact on depressive symptoms in older people. Our results raise questions about the effectiveness of the current noise control policy to improve the well-being of residents living near the airport.