Women living in the most deprived areas are over 60% more likely to have anxiety as women living in richer areas. However, whether men live in poorer or richer areas seems to make very little difference to their anxiety levels, according to new research we conducted at the University of Cambridge.
The disorder that we looked at in our study of over 18,000 British people was generalised anxiety disorder, which is characterised by excessive uncontrollable worry about a number of life circumstances, from work and finances to relationships and health. The worry could extend to major or minor matters, it could be about anything, and it is very difficult to control.
People with generalised anxiety disorder often think that something negative will happen in the future without this belief being necessarily grounded in reality. They also suffer from symptoms such as restlessness, insomnia and irritability. They may find it difficult to concentrate on tasks at work or school, and their muscles may feel tense, which can lead to frequent headaches, back pain or joint pain. They might also find it hard to fall or stay asleep at night, and this in turn, can make them feel very tired the next day and impairs their concentration further.
While some studies have looked at the personal factors that can increase the risk of anxiety, such as personal income and education, there is a scarcity of studies looking at the effects of places on mental health.
We do know from research that the residential environment has a significant effect on health more generally. Studies have shown that living in areas characterised by high income inequality can lead to an increased risk of serious medical conditions and even early death.
But what about anxiety?
Well, now we know. Our study shows that the places which we inhabit can increase our risk of anxiety – but more so for women. I teamed up with filmmaker Ryd Cook to create the short video explainer below.
But why is women’s mental health more affected by living in deprived areas than men’s? A number of reasons can account for this. First, women tend to spend more time in their residential environment, because they are more likely than men to have part-time work, take care of children, and carry out domestic activities, such as grocery shopping. If women spend more time at home and also live in a poor area, then they are more likely to be exposed to the stress and strain associated with living in deprivation.
Second, the sexes seem to be differentially affected by various aspects of their environment. For example, fear of being assaulted and neighbourhood safety is a particular concern for women. If women think their neighbourhoods or communities are unsafe, they are less likely to go for walks and engage in physical activity. And engaging in physical activity has been shown to have tremendous benefits for mental health.
Third, being embedded in social networks is particularly important for women’s mental health. If women live in a deprived area and perceive their community to be unsafe, they are less likely to reach out to their neighbours and form relationships. This, too, can have a negative impact on their mental health.
Fourth, women and men seem to experience and manifest the effects of stress differently. Women exposed to stress are more likely to internalise its effects and develop mental health problems, while men who are exposed to stress are more likely to externalise its effects and develop conditions, such as alcohol abuse.
More research is needed on this, but our findings on area deprivation and anxiety, and the discussion around the possible underlying mechanisms are intriguing. It means that investing in local areas will not benefit men and women living in those places in the same way. And this is important to know at a time of scarce economic resources.
In our research, we also found that it isn’t a particular aspect of deprivation that is harmful for women’s mental health, rather it is the overall effect of living in deprivation that increases the risk of anxiety in the latter group.
Women are increasingly taking on multiple roles in modern society – many have full-time jobs, and take care of children as well as their elderly parents or relatives. All of this adds to their burden and stress, and even more so if they are living in deprivation.
It is no wonder, then, that living in a poor area is linked to generalised anxiety disorder in women. I think this needs to be considered by policy makers and community planners, particularly as the number of women living in deprived circumstances is large worldwide and anxiety is one of the most common mental health conditions today.
Olivia Remes received a PhD studentship from the National Institute for Health Research.
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