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Do Municipal Contexts Matter for Adolescent Mental Health? A Within-Municipality Analysis of Nationwide Norwegian Survey Data Across Six Years

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Abstract

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.

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Notes

  1. 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.

  2. 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).

  3. 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.

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Acknowledgements

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).

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  1. Department of Education, Gwangju National University of Education, Yeonjingwan 303, 55 Pilmun-daero, Buk-gu, Gwangju, South Korea

    Baeksan Yu

  2. Department of Psychology, University of Oslo, Oslo, Norway

    Tilmann von Soest & Ragnhild Bang Nes

  3. Norwegian Social Research (NOVA), Oslo Metropolitan University, Oslo, Norway

    Tilmann von Soest

  4. Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway

    Ragnhild Bang Nes

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Correspondence to Baeksan Yu.

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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.

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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 52, 169–182 (2024). https://doi.org/10.1007/s10802-023-01123-3

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