Association between neighborhood social cohesion and depressive symptoms: findings from the CRONICAS Cohort Study

Purpose: While the protective role of neighborhood social cohesion against mental disorders is well-documented in high-income countries, evidence from resource-constrained settings remains scarce. This study evaluated the cross-sectional and longitudinal associations between neighborhood social cohesion and depressive symptoms in a Peruvian cohort. Methods: Data from the CRONICAS Cohort Study were analyzed. The primary outcomes were the prevalence and incidence of depressive symptoms, assessed via the Center for Epidemiologic Studies Depression Scale (CES-D). Neighborhood social cohesion, conceptualized through trust, reciprocity, and solidarity, was measured using a 4-item scale and categorized into tertiles. Single variable and multivariable-adjusted Poisson regression models were used to estimate incidence rate ratios (IRR) and 95% confidence intervals (95% CI). Results: Among 3533 participants (mean age 55.8 ± 12.7 years; 51.5% female), baseline prevalence of depressive symptoms was 18.6% (95%CI: 17.3%–19.9%). Middle and high levels of social cohesion were associated with a 27% (95% CI: 13%–38%) and 47% (95% CI: 19%–66%) lower prevalence of symptoms at baseline. We identified 221 incident cases (4.0 cases per 100 person-years, 95% CI: 3.5–4.6). High social cohesion was associated with an adjusted 46% (95% CI: 9%–68%) reduction in the risk of developing depressive symptoms over 30 months. Discussion: Higher neighborhood social cohesion was significantly associated with a reduced prevalence and a lower incidence of developing depressive symptoms. These findings suggest that interventions aimed at fostering community trust and social capital may represent a viable strategy for mental health prevention in resource-constrained environments.