Road Infrastructure and Traffic Affect Community Members’ Mental Health

Communities very isolated by roadways and traffic patterns tended to have more schizophrenia-related hospital visits, according to a new federally funded study by Columbia University Mailman School of Public Health and Brown University. The researchers also found that this effect was independent from traffic-caused air pollution. While studies have shown a link between traffic-related exposures such as air pollution and noise and adverse mental health outcomes, until now there has been little research on the role of road infrastructure itself in isolating communities and and how that might affect the mental health of people who live there. The study is published in Environmental Epidemiology.

“Imagine an environment where cars are present, but do not dominate, and that also has robust pedestrian traffic and walkable routes to neighbors’ homes, and where you can see kids playing outside and neighbors congregating to talk,” said study first author Jaime Benavides, an investigator in epidemiology at Brown, and formerly of Columbia Mailman School of Public Health. “We wanted to home in on the road infrastructure that prevents people from interacting and learn how that influences their mental health.” 

The research team conducted ZIP code-level analyses to investigate the association between mental health hospital visits and community isolation in New York, using annual New York State Department of Health counts of hospital visits related to mood, anxiety, adjustment disorders and schizophrenia.

They quantified community isolation using a custom metric developed while at Columbia Mailman School. Called the Community Severance Index, it takes into account the role of roads, traffic and lack of pedestrian infrastructure (like sidewalks and crosswalks) in the physical and social disconnection of communities. The development of the index was led by Marianthi-Anna Kioumourtzoglou, formerly associate professor of Environmental Health Sciences at Columbia, now affiliated with Brown’s Center for Climate, Environment and Health, who also co-led this study. Jeff Goldsmith, associate professor of Biostatistics at Columbia Mailman School is a co-author of the research.

“We have increasing evidence that air pollution impacts mental health,” Kioumourtzoglou said. “One of the solutions proposed is to move towards an electrified vehicle fleet. While this will result in reduced emissions, which is absolutely fantastic, what our study shows is that might not be enough. We need to move away from car dependence and towards building healthier places and communities that bring people together instead of isolating them.”

Urban living, in general, has been linked to increased risk of anxiety, mood and schizophrenia disorders. In this study, the strongest association had to do with schizophrenia: higher levels of community isolation were associated with increased schizophrenia-related hospital visits. The effect was similar across age groups.

The researchers note that while scientists are still researching the causes, prevention and treatment of mental illness and mood disorders, urban environmental exposures — specifically, traffic patterns and road infrastructure — are things that can be addressed from an urban planning perspective. They further believe that reducing vehicular traffic, creating more easily accessible parks and limiting highways and roads that cut through the middle of communities can improve collective mental wellbeing.

While the study didn’t explore the reasons behind this effect, a community cut off from others by traffic and road infrastructure has limited access to goods, services and social connections. The researchers point out that mental health may be impacted through different means, including discouraging walking and physical activity, increasing psychological stress due to road safety concerns and limiting social contacts among community residents.

 These findings draw attention to an overlooked urban exposure and highlight the need for further research on how features of city design may influence mental health, according to the authors. 

“The way we design, build, and use our cities matters for physical and mental health,” said Jeff Goldsmith of Columbia Mailman School. “Busy roads that cut through neighborhoods make it harder for residents to engage with their community, and that has negative effects. Finding ways to reduce isolation coming from road infrastructure could reverse those effects.”

The researchers plan to build upon their findings by developing a measurement for community isolation that would be generalizable to other large U.S. cities and looking at the effect of the combined environmental factors of extreme heat, air pollution and community isolation on the mental health of elderly people.

This work was supported by the National Institute of Environmental Health Sciences (P30 ES009089, R01 ES030616) and by the National Institute on Aging (P20 AG093975).