The association between urban land use and depressive symptoms in young adulthood: a FinnTwin12 cohort study.

ABSTRACT

BACKGROUND: Depressive symptoms lead to a serious public health burden and are considerably affected by the environment. Land use, describing the urban living environment, influences mental health, but complex relationship assessment is rare. OBJECTIVE: We aimed to examine the complicated association between urban land use and depressive symptoms among young adults with differential land use environments, by applying multiple models. METHODS: We included 1804 individual twins from the FinnTwin12 cohort, living in urban areas in 2012. There were eight types of land use exposures in three buffer radii. The depressive symptoms were assessed through the General Behavior Inventory (GBI) in young adulthood (mean age 24.1). First, K-means clustering was performed to distinguish participants with differential land use environments. Then, linear elastic net penalized regression and eXtreme Gradient Boosting (XGBoost) were used to reduce dimensions or prioritize for importance and examine the linear and nonlinear relationships. RESULTS: Two clusters were identified one is more typical of city centers and another of suburban areas. A heterogeneous pattern in results was detected from the linear elastic net penalized regression model among the overall sample and the two separated clusters. Agricultural residential land use in a 100 m buffer contributed to GBI most (coefficient 0.097) in the "suburban" cluster among 11 selected exposures after adjustment with demographic covariates. In the "city center" cluster, none of the land use exposures was associated with GBI, even after further adjustment with social indicators. From the XGBoost models, we observed that ranks of the importance of land use exposures on GBI and their nonlinear relationships are also heterogeneous in the two clusters. IMPACT This study examined the complex relationship between urban land use and depressive symptoms among young adults in Finland. Based on the FinnTwin12 cohort, two distinct clusters of participants were identified with different urban land use environments at first. We then employed two pluralistic models, elastic net penalized regression and XGBoost, and revealed both linear and nonlinear relationships between urban land use and depressive symptoms, which also varied in the two clusters. The findings suggest that analyses, involving land use and the broader environmental profile, should consider aspects such as population heterogeneity and linearity for comprehensive assessment in the future.