The study looked at hospitalization and opportunity data from 12 states that spanned geography, population, rurality and other factors to offer a comprehensive view of opportunity and mental health encounters. (iStock)
Researchers at Monroe Carell Jr. Children’s Hospital at Vanderbilt have published new research that finds children and youth who live in neighborhoods with less opportunity have higher rates of hospitalization for specific mental health conditions.
The study, published in the journal Psychiatric Services, is the first to examine relationships between neighborhood opportunity and specific mental health-related diagnoses and hospitalizations at a population level. The study found the overall incidence rate of mental health hospitalizations among children and youth ages 5-24 across 12 U.S. states in 2021 was 74.5 per 10,000 children and youth. Rates were higher among those living in very low-opportunity areas (76.9 per 10,000) compared to those in very high-opportunity areas (67.3 per 10,000), representing a 14% higher incidence rate of hospitalizations for mental health conditions.
There were also differences in specific diagnoses. Hospitalizations for psychotic disorders, for example, were nearly 2.5 times higher in areas of very low opportunity compared to areas with very high opportunity, while hospitalizations for anxiety were highest in areas of high opportunity.
“This study shows that where children live matters for their mental health in very real ways,” said Ankita Gupta, MD, a second-year fellow in the Division of Pediatric Hospital Medicine at Monroe Carell and lead author of the study. “We found that young people in lower-opportunity neighborhoods are more likely to be hospitalized for serious mental health conditions, highlighting how community environments shape risk. By looking at specific mental health diagnoses, we now have a more detailed understanding of how different conditions may be influenced by neighborhood factors.”
Opportunity is measured by the Child Opportunity Index 3.0, a publicly available, multidimensional metric that captures neighborhood conditions that influence children’s health, like education, housing, access to healthy food, environment and societal factors. The COI 3.0 contains data on every U.S. census tract from 2012-2023.
The study builds on prior research linking neighborhood conditions to health outcomes by examining how the Child Opportunity Index relates to mental health-related hospitalizations across specific psychiatric diagnoses at the national level. This work provides a more detailed understanding of opportunity gaps and how neighborhood conditions may be associated with youth mental health outcomes.
It included hospitalization and opportunity data from 12 states that spanned geography, population, rurality and other factors to offer a comprehensive view of opportunity and mental health encounters. Researchers also noted a significant variation in hospitalization rates by state, adding emphasis to future research and policy interventions.
“Our findings point to the need for solutions that go beyond the hospital and address the environments where children live. Future research should explore what is driving these differences, so that interventions can be tailored to the needs of the communities,” Gupta said.
“Policy efforts might include expansion of school-based mental health services, strengthening of community programs, and improvement in access to telemedicine services.”
