Despite growing concerns about substantial socio-economic differences between districts in many developed nations, limited attention has been paid to how adolescent mental health may be shaped by district characteristics. A few studies have shown that adolescent mental health is related to contextual factors such as district socio-economic status, neighborhood disorder, and quality of infrastructure. However, prior estimates may be an artifact of unmeasured differences between districts. To address these concerns, we used data from the nationwide Norwegian Ungdata surveys (N = 278,764), conducted across the years 2014 to 2019. We applied three-level hierarchical linear models to examine within-municipality associations between municipal factors and adolescent mental health in the domains of internalizing problems (i.e., depressive symptoms), externalizing problems (i.e., behavioral problems), and well-being (i.e., self-esteem), thereby accounting for all time-invariant municipality-level confounders. Our results showed that municipal-level safety, infrastructure, and youth culture are associated with adolescent mental health problems. Further, cross-level interaction models indicated gender-specific associations, with stronger associations of municipality infrastructure and community belongingness with increased self-esteem and reduced delinquent behaviors among girls than boys. Our findings highlight that municipality-level interventions may be a feasible strategy for adolescent mental health, even in a society characterized by low inequality and high redistribution.
This is a preview of subscription content,to check access.
Access this article
Culture encompasses shared attitudes and values that operate at a higher level. In this regard, Ingram et al. (2018) argue that cultural variables should be treated as collective measures. We thus constructed youth culture by aggregating respondents’ own perceptions of municipal characteristics or peer groups.
We carefully considered a potential multi-collinearity problem and examined within-variations at municipal level. Our centering approach can effectively identify within- and between-associations relieving multi-collinearity issues. The VIF values of all entered variables were less than 10 (Franke, 2010), and we confirmed that results do not notably differ from the models excluding variables with higher VIF > 4 (i.e., proportions of residents with immigrant background).
As a supplemental analysis we examined the degree in which the findings from level 1 variables were robust to unobserved confounding (Xu et al., 2019; see Table S2 in the Online Supplement). Regarding depressive symptoms and self-esteem, we found that adolescents’ health and sleep problems, experience of being bullied, and school satisfaction were particularly robust to unobserved confounding. For adolescent behavioral problems, school satisfaction and social media use were robust.
Abebe, D. S., Frøyland, L. R., Bakken, A., & von Soest, T. (2016). Municipal-level differences in depressive symptoms among adolescents in Norway: Results from the cross-national ungdata study. Scandinavian Journal of Public Health, 44(1), 47–54.
Adjaye-Gbewonyo, K., Kawachi, I., Subramanian, S. V., & Avendano, M. (2018). High social trust associated with increased depressive symptoms in a longitudinal south african sample. Social Science & Medicine, 197, 127–135.
Aldridge, J. M., & McChesney, K. (2018). The relationships between school climate and adolescent mental health and wellbeing: A systematic literature review. International Journal of Educational Research, 88, 121–145.
Alegría, M., NeMoyer, A., Falgàs Bagué, I., Wang, Y., & Alvarez, K. (2018). Social determinants of mental health: Where we are and where we need to go. Current Psychiatry Reports, 20(11), 1–13.
Allison, P. D. (2009). Fixed effects regression models. SAGE publications.
Aminzadeh, K., Denny, S., Utter, J., Milfont, T. L., Ameratunga, S., Teevale, T., & Clark, T. (2013). Neighborhood social capital and adolescent self-reported wellbeing in New Zealand: A multilevel analysis. Social Science & Medicine, 84, 13–21.
Angell, E., Flo, Y., & Grimsrud, G. M. (2016). The rural and regional policy of Norway. Institutions, development features and current instruments. Uni Research Rokkansenteret.
Assari, S., Caldwell, C. H., & Zimmerman, M. A. (2015). Perceived neighborhood safety during adolescence predicts subsequent deterioration of subjective health two decades later; gender differences in a racially-diverse sample. International Journal of Preventive Medicine, 6, 117.
Balsa, A. I., French, M. T., & Regan, T. L. (2014). Relative deprivation and risky behaviors. Journal of Human Resources, 49(2), 446–471.
Bartels, M., Cacioppo, J. T., van Beijsterveldt, T. C., & Boomsma, D. I. (2013). Exploring the association between well-being and psychopathology in adolescents. Behavior Genetics, 43(3), 177–190.
Baselmans, B. M., Willems, Y. E., van Beijsterveldt, C. E. M., Ligthart, L., Willemsen, G., Dolan, C. V., & Bartels, M. (2018). Unraveling the genetic and environmental relationship between well-being And depressive symptoms throughout the lifespan. Frontiers in Psychiatry, 9, 261. https://doi.org/10.3389/fpsyt.2018.00261
Bassett, E., & Moore, S. (2013). Gender differences in the social pathways linking neighborhood disadvantage to depressive symptoms in adults. Plos One, 8(10), https://doi.org/10.1371/journal.pone.0076554
Bau, N. (2021). Can policy change culture? Government pension plans and traditional kinship practices. American Economic Review, 111(6), 1880–1917.
Bhansali, R., & Trivedi, K. (2008). Is academic anxiety gender specific: A comparative study. Journal of Social Sciences, 17(1), 1–3. https://doi.org/10.1080/09718923.2008.11892627
Bird, E. L., Ige, J. O., Pilkington, P., Pinto, A., Petrokofsky, C., & Burgess-Allen, J. (2018). Built and natural environment planning principles for promoting health: An umbrella review. Bmc Public Health, 18(1), 1–13.
Blankenship, K. M., Bray, S. J., & Merson, M. H. (2000). Structural interventions in public health. Aids, 14, S11–S21.
Brazil, N., & Clark, W. A. (2017). Individual mental health, life course events and dynamic neighborhood change during the transition to adulthood. Health & Place, 45, 99–109.
Breistøl, S., Clench-Aas, J., Van Roy, B., & Raanaas, R. K. (2017). Association between participating in noncompetitive or competitive sports and mental health among adolescents–a Norwegian population-based cross-sectional study. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 5(1), 28–38.
Cheung, F., & Lucas, R. E. (2014). Assessing the validity of single-item life satisfaction measures: Results from three large samples. Quality of Life Research, 23(10), 2809–2818.
Christian, H., Zubrick, S. R., Foster, S., Giles-Corti, B., Bull, F., Wood, L., & Boruff, B. (2015). The influence of the neighborhood physical environment on early child health and development: A review and call for research. Health & Place, 33, 25–36.
Chung, H. L., & Docherty, M. (2011). The protective function of neighborhood social ties on psychological health. American Journal of Health Behavior, 35(6), 785–796.
Clare, P. J., Dobbins, T. A., & Mattick, R. P. (2019). Causal models adjusting for time-varying confounding—a systematic review of the literature. International Journal of Epidemiology, 48(1), 254–265.
Cuevas, C. A., Finkelhor, D., Shattuck, A., Turner, H., & Hamby, S. L. (2013). Children’s exposure to violence and the intersection between delinquency and victimization (NCJ240555). Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice.
Das, J. K., Salam, R. A., Lassi, Z. S., Khan, M. N., Mahmood, W., Patel, V., & Bhutta, Z. A. (2016). Interventions for adolescent mental health: An overview of systematic reviews. Journal of Adolescent Health, 59(4), S49–S60.
Deighton, J., Humphrey, N., Belsky, J., Boehnke, J., Vostanis, P., & Patalay, P. (2018). Longitudinal pathways between mental health difficulties and academic performance during middle childhood and early adolescence. British Journal of Developmental Psychology, 36(1), 110–126.
Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behavioral Science, 19(1), 1–15.
Dickhäuser, O., Janke, S., Daumiller, M., & Dresel, M. (2021). Motivational school climate and teachers’ achievement goal orientations: A hierarchical approach. British Journal of Educational Psychology, 91(1), 391–408.
Espinosa, E. M., Sorensen, J. R., & Lopez, M. A. (2013). Youth pathways to placement: The influence of gender, mental health need and trauma on confinement in the juvenile justice system. Journal of Youth and Adolescence, 42(12), 1824–1836.
Fairbrother, M. (2014). Two multilevel modeling techniques for analyzing comparative longitudinal survey datasets. Political Science Research and Methods, 2, 119–140.
Finkel, S. E., McCauley, J. F., Neureiter, M., & Belasco, C. A. (2021). Community violence and support for violent extremism: Evidence from the Sahel. Political Psychology, 42(1), 143–161.
Finlay, J., Esposito, M., Kim, M. H., Gomez-Lopez, I., & Clarke, P. (2019). Closure of ‘third places’? Exploring potential consequences for collective health and wellbeing. Health & Place, 60, 102225.
Fong, P., Cruwys, T., Haslam, C., & Haslam, S. A. (2019). Neighborhood identification and mental health: How social identification moderates the relationship between socioeconomic disadvantage and health. Journal of Environmental Psychology, 61, 101–114.
Fong, P., Cruwys, T., Robinson, S. L., Haslam, S. A., Haslam, C., Mance, P. L., & Fisher, C. L. (2021). Evidence that loneliness can be reduced by a whole-of-community intervention to increase neighborhood identification. Social Science & Medicine, 113909.
Fowler, K., Wareham-Fowler, S., & Barnes, C. (2013). Social context and depression severity and duration in canadian men and women: Exploring the influence of social support and sense of community belongingness. Journal of Applied Social Psychology, 43, E85–E96.
Franke, G. R. (2010). Multicollinearity. Wiley International Encyclopedia of Marketing.
Galster, G. C. (2012). The mechanism (s) of neighborhood effects: Theory, evidence, and policy implications. Neighborhood effects research: New perspectives (pp. 23–56). Springer.
Gearhart, M. C. (2019). Preventing neighborhood disorder: Comparing alternative models of collective efficacy theory using structural equation modeling. American Journal of Community Psychology, 63, 168–178.
Hankin, B. L., Young, J. F., Abela, J. R., Smolen, A., Jenness, J. L., Gulley, L. D., & Oppenheimer, C. W. (2015). Depression from childhood into late adolescence: influence.
Harding, D. J., & Hepburn, P. (2014). Cultural mechanism in neighborhood effects research in the United States. Sociologia Urbana E Rurale, 103, 37–73.
Haugan, T., Muggleton, S., & Myhr, A. (2021). Psychological distress in late adolescence: The role of inequalities in family affluence and municipal socioeconomic characteristics in Norway. PloS One, 16(7), e0254033.
Helliwell, J., Layard, R., & Sachs, J. D. (Eds.). World Happiness Report, 2020. New York: Sustainable Development Solutions Network.
Heradstveit, O., Nilsen, S. A., Breivik, K., Bakken, A., Haug, T., & Stormark, K. M. (2022). Psychometric properties of a short self-report measure of rule-breaking behaviour among adolescents: Findings from the Ungdata survey. Scandinavian Journal of Public Health, https://doi.org/10.1177/14034948221104650
Hoare, E., Thorisdóttir, I. E., Kristjansson, A. L., Sigfusdóttir, I. D., Hayward, J., Allender, S., & Jacka, F. (2019). Lessons from Iceland: Developing scalable and sustainable community approaches for the Prevention of mental disorders in young Australians. Mental Health & Prevention, 15, 200166.
Ingoldsby, E. M., Shaw, D. S., Winslow, E., Schonberg, M., Gilliom, M., & Criss, M. M. (2006). Neighborhood disadvantage, parent–child conflict, neighborhood peer relationships, and early antisocial behavior problem trajectories. Journal of Abnormal Child Psychology, 34(3), 293–309.
Ingram, J. R., Terrill, W., & PAOLINE, E. A. III (2018). Police culture and officer behavior: Application of a multilevel framework. Criminology, 56(4), 780–811.
Kandel, D. B., & Davies, M. (1982). Epidemiology of depressive mood in adolescents: An empirical study. Archives of General Psychiatry, 39(10), 1205–1212.
Kendler, K. S., Myers, J. M., & Keyes, C. L. (2011). The relationship between the genetic and environmental influences on common externalizing psychopathology and mental wellbeing. Twin Research and Human Genetics, 14(6), 516–523.
Khanijahani, A., & Sualp, K. (2022). Adverse childhood experiences, neighborhood support, and internalizing and externalizing mental disorders among 6–17 years old US children: Evidence from a Population-based study. Community Mental Health Journal, 58(1), 166–178.
Kroneman, L., Loeber, R., & Hipwell, A. E. (2004). Is neighborhood context differently related to externalizing problems and delinquency for girls compared with boys? Clinical Child and Family Psychology Review, 7(2), 109–122.
Krueger, R. F. (1999). The structure of common mental disorders. Archives of General Psychiatry, 56(10), 921–926.
Leventhal, T., & Brooks-Gunn, J. (2000). The neighborhoods they live in: The effects of neighborhood residence on child and adolescent outcomes. Psychological Bulletin, 126(2), 309–337.
Liao, T. F. (2021). Income inequality, Social Comparison, and happiness in the United States. Socius, 7, 2378023120985648.
Lintunen (Ed.). The handbook of Behavior Change (Cambridge Handbooks in Psychology, pp. 237–250). Cambridge: Cambridge University Press.
Martela, F., Greve, B., Rothstein, B., & Saari, J. (2020). The nordic exceptionalism: What explains why the nordic countries are constantly among the happiest in the world. In J. E. D. Neve,.
Mehtälä, M. A. K., Sääkslahti, A. K., Inkinen, M. E., & Poskiparta, M. E. H. (2014). A socio-ecological approach to physical activity interventions in childcare: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 11(1), 1–12.
Meier, M. H., Hill, M. L., Small, P. J., & Luthar, S. S. (2015). Associations of adolescent cannabis use with academic performance and mental health: A longitudinal study of upper middle-class youth. Drug and Alcohol Dependence, 156, 207–212.
Milam, A. J., Furr-Holden, C. D., Whitaker, D., Smart, M., Leaf, P., & Cooley-Strickland, M. (2012). Neighborhood environment and internalizing problems in african american children. Community Mental Health Journal, 48(1), 39–44.
Moore, S. E., Norman, R. E., Sly, P. D., Whitehouse, A. J., Zubrick, S. R., & Scott, J. (2014). Adolescent peer aggression and its association with mental health and substance use in an australian cohort. Journal of Adolescence, 37(1), 11–21.
Narr, R. K., Allen, J. P., Tan, J. S., & Loeb, E. L. (2019). Close friendship strength and broader peer group desirability as differential predictors of adult mental health. Child Development, 90(1), 298–313.
Nes, R. B., Hansen, T., Eilertsen, M., Røysamb, E., & Nilsen, T. S. (2021). Livskvalitet i Norge. I Folkehelserapporten – Helsetilstanden i Norge. Folkehelseinstituttet.
Nieuwenhuis, J., & Hooimeijer, P. (2016). The association between neighbourhoods and educational achievement, a systematic review and meta-analysis. Journal of Housing and the Built Environment, 31(2), 321–347.
Nordbø, E. C. A., Nordh, H., Raanaas, R. K., & Aamodt, G. (2020). Promoting activity participation and well-being among children and adolescents: A systematic review of neighborhood built-environment determinants. JBI Evidence Synthesis, 18(3), 370–458.
of gender, Development, genetic susceptibility, and peer stress. Journal of Abnormal Psychology, 124(4), 803–816.
Olweus, D. (1989). Prevalence and incidence in the study of antisocial behavior: Definitions and measurements. Cross-national research in self-reported crime and delinquency (pp. 187–201). Springer.
Patalay, P., & Fitzsimons, E. (2016). Correlates of mental illness and wellbeing in children: Are they the same? Results from the UK Millennium Cohort Study. Journal of the American Academy of Child & Adolescent Psychiatry, 55(9), 771–783.
Pickover, A. M., Bhimji, J., Sun, S., Evans, A., Allbaugh, L. J., Dunn, S. E., & Kaslow, N. J. (2021). Neighborhood disorder, social support, and outcomes among violence-exposed african american women. Journal of Interpersonal Violence, 36(7–8), NP3716–NP3737.
Reardon, S. F., Fahle, E. M., Kalogrides, D., Podolsky, A., & Zárate, R. C. (2019). Gender achievement gaps in US school districts. American Educational Research Journal, 56(6), 2474–2508.
Richmond-Rakerd, L. S., D’Souza, S., Milne, B. J., Caspi, A., & Moffitt, T. E. (2021). Longitudinal associations of mental disorders with physical diseases and mortality among 2.3 million New Zealand citizens. JAMA Network Open, 4(1), e2033448.
Rollings, K. A., Wells, N. M., Evans, G. W., Bednarz, A., & Yang, Y. (2017). Housing and neighborhood physical quality: Children’s mental health and motivation. Journal of Environmental Psychology, 50, 17–23.
Salmon, J., Hesketh, K., Arundell, L., Downing, K., & Biddle, S. (2020). Changing Behavior Using Ecological Models. In M. Hagger, L. Cameron, K. Hamilton, N. Hankonen, & T.
Sameroff, A. (2009). The transactional model of development: How children and contexts shape each other. American Psychological Association.
Sassenberg, K., Matschke, C., & Scholl, A. (2011). The impact of discrepancies from ingroup norms on group members’ well-being and motivation. European Journal of Social Psychology, 41(7), 886–897.
Schmalbach, B., Zenger, M., Tibubos, A. N., Kliem, S., Petrowski, K., & Brähler, E. (2021). Psychometric properties of two brief versions of the Hopkins Symptom Checklist: HSCL-5 and HSCL-10. Assessment, 28(2), 617–631.
Schmidt-Catran, A. W., & Fairbrother, M. (2016). The random effects in multilevel models: Getting them wrong and getting them right. European Sociological Review, 32, 23–38.
Shields, S. A. (2008). Gender: An intersectionality perspective. Sex Roles, 59, 301–311.
Simone, C., Carolin, L., Max, S., & Reinhold, K. (2013). Associations between community characteristics and psychiatric admissions in an urban area. Social Psychiatry and Psychiatric Epidemiology, 48(11), 1797–1808.
Smokowski, P. R., Bacallao, M. L., Cotter, K. L., & Evans, C. B. (2015). The effects of positive and negative parenting practices on adolescent mental health outcomes in a multicultural sample of rural youth. Child Psychiatry & Human Development, 46(3), 333–345.
Solmi, M., Radua, J., Olivola, M., Croce, E., Soardo, L., de Pablo, S., & Fusar-Poli, G., P (2021). Age at onset of mental disorders worldwide: Large-scale meta-analysis of 192 epidemiological studies. Molecular Psychiatry. https://doi.org/10.1038/s41380-021-01161-7
Trotta, A., Arseneault, L., Caspi, A., Moffitt, T. E., Danese, A., Pariante, C., & Fisher, H. L. (2020). Mental health and functional outcomes in young adulthood of children with psychotic symptoms: A longitudinal cohort study. Schizophrenia Bulletin, 46(2), 261–271.
Van Droogenbroeck, F., Spruyt, B., & Keppens, G. (2018). Gender differences in mental health problems among adolescents and the role of social support: Results from the belgian health interview surveys 2008 and 2013. Bmc Psychiatry, 18(1), 1–9.
Visser, K., Bolt, G., Finkenauer, C., Jonker, M., Weinberg, D., & Stevens, G. W. (2021). Neighborhood deprivation effects on young people’s mental health and well-being: A systematic review of the literature. Social Science & Medicine, 113542.
von Soest, T., & Wichstrøm, L. (2014). Secular trends in depressive symptoms among norwegian adolescents from 1992 to 2010. Journal of Abnormal Child Psychology, 42, 403–415.
von Soest, T., Wichstrøm, L., & Kvalem, I. L. (2016). The development of global and domain-specific self-esteem from age 13 to 31. Journal of Personality and Social Psychology, 110(4), 592–608.
von Soest, T., Kozák, M., Rodríguez-Cano, R., Fluit, D. H., Cortés-García, L., Ulset, V. S., & Bakken, A. (2022). Adolescents’ psychosocial well-being one year after the outbreak of the COVID-19 pandemic in Norway. Nature Human Behaviour, 1–12.
Whitley, R., & Prince, M. (2005). Fear of crime, mobility and mental health in inner-city London, UK. Social Science & Medicine, 61(8), 1678–1688.
Wichstrom, L. (1995). Harter’s Self-Perception Profile for Adolescents: Reliability, validity, and evaluation of the question format. Journal of Personality Assessment, 65(1), 100–116.
Wight, R. G., Aneshensel, C. S., Botticello, A. L., & Sepúlveda, J. E. (2005). A multilevel analysis of ethnic variation in depressive symptoms among adolescents in the United States. Social Science & Medicine, 60(9), 2073–2084.
Williams, G., & Smith, A. P. (2016). Using single-item measures to examine the relationships between work, personality, and well-being in the workplace. Psychology, 7, 753–767.
Wu, Q., Lu, D., & Kang, M. (2015). Social capital and the mental health of children in rural China with different experiences of parental migration. Social Science & Medicine, 132, 270–277.
Xiao, Q., Berrigan, D., & Matthews, C. E. (2017). A prospective investigation of neighborhood socioeconomic deprivation and self-rated health in a large US cohort. Health & Place, 44, 70–76.
Xu, R., Frank, K. A., Maroulis, S. J., & Rosenberg, J. M. (2019). Konfound: Command to quantify robustness of causal inferences. The Stata Journal, 19(3), 523–550.
Yu, B., & Kelly, S. (2019). The non-cognitive returns to vocational school tracking: South korean evidence. International Journal of Educational Research, 98, 379–394.
Yu, B., Lim, H., & Kelly, S. (2019). Does receiving a school free lunch lead to a stigma effect? Evidence from a longitudinal analysis in South Korea. Social Psychology of Education, 22, 291–319.
Zhang, Y., Dai, X., Yu, X., & Gao, N. (2020). Urban integration of land-deprived households in China: Quality of living and social welfare. Land Use Policy, 96, 104671.
Zijlema, W. L., Klijs, B., Stolk, R. P., & Rosmalen, J. G. (2015). (Un) healthy in the city: Respiratory, cardiometabolic and mental health associated with urbanity. PLoS One, 10(12), e0143910.
An earlier version of this manuscript was presented at the 2022 British Society for Population Studies annual meeting. We appreciate all their comments and suggestions to improve the paper. This work was supported by the Research Council of Norway (grant number 288083 and 300816).
Compliance with Ethical Standards
This study used data from the Norwegian nationwide Ungdata surveys. All students gave their informed consent prior to their participation in the study. We have access to the data through the Norwegian Agency for Shared Services in Education and Research. The authors have no competing interests to declare that are relevant to the content of this article.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Yu, B., von Soest, T. & Nes, R.B. Do Municipal Contexts Matter for Adolescent Mental Health? A Within-Municipality Analysis of Nationwide Norwegian Survey Data Across Six Years. Res Child Adolesc Psychopathol (2023). https://doi.org/10.1007/s10802-023-01123-3