Urban upbringing and psychiatric disorders in the United States: A racial comparison

Background: Studies that link urbanicity to mental health are mixed depending on outcome and context. More research is needed to examine whether the urban upbringing effect holds true across racial populations in a large and diverse country like the United States. Methods: We analyzed two large datasets that were administered contemporaneously with similar methods: The National Comorbidity Survey-Replication (NCS-R, Whites) and the National Survey of American Life (NSAL, Blacks). We ran multivariable logistic regression models to examine the associations between area of upbringing (urban/large city, other, rural) and six psychiatric disorders, controlling for sex, age, years of education and income-to-poverty ratio (and ethnicity in the NSAL). We performed these analyses in both the NCS-R and the NSAL separately. Results: The majority (58.97%) of the White sample grew up in the 'other' category (i.e. small town, small city, or suburb of a large city), whereas a much larger percentage (39.89%) of the Black sample grew up in a large city. In the White sample, urban upbringing was not associated with any of the psychiatric disorders at a conventional level of statistical significance. In the Black sample, urban upbringing was associated with greater odds of having mood disorder, alcohol use disorder and drug use disorder, but was not significantly associated with anxiety disorders, PTSD, or eating disorders. Conclusions: Urban upbringing was not associated with psychiatric disorders among Whites, but was associated with greater odds of mood disorders, alcohol us disorder and drug use disorder among Blacks. Future research can elucidate how differences in urban upbringing between Whites and Blacks are linked to differences in risk for psychiatric disorders.