What question did this study set out to answer?

To identify sociodemographic, structural, and clinical factors associated with longitudinal improvements in depression and anxiety symptoms among primary care clients in a structurally marginalized urban neighborhood.

August 14, 2026BMC Public HealthOpen Access

A cohort study examining factors associated with improvement in mental health symptoms among residents of a low-income neighborhood facing multiple axes of marginalization

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Authors

RSRiya SharmaAIDS Vancouver WZWendy ZhangUniversity of Canterbury JLJenny LiThe Ohio State University Wexner Medical Center

Discussion

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Implication

Cohort study reveals food insecurity and substance use hinder mental health improvement in marginalized urban residents, highlighting the necessity of structural interventions.

Key Points

To identify sociodemographic, structural, and clinical factors associated with longitudinal improvements in depression and anxiety symptoms among primary care clients in a structurally marginalized urban neighborhood.
Enrolled clients (N=455; median age 46 years; 23.6% currently homeless) at a low-barrier integrated primary care clinic in Vancouver, Canada, with follow-up surveys every 6 months between June 2021 and December 2023.
Assessed depression and anxiety symptoms using the CESD-10 and GAD-7 screening tools, respectively.
Evaluated predictors of symptom improvement (score reduction to <10 following a prior score ≥10) using logistic regression with Generalized Estimating Equations.
Subsequent symptom improvement occurred in 43.3% of participants with high baseline depression (CESD-10 ≥10) and 54.5% of those with high baseline anxiety (GAD-7 ≥10).
Depression improvement was less likely with food insecurity (aOR=0.54; 95% CI, 0.37–0.78), higher loneliness (aOR=0.77; 95% CI, 0.65–0.92), and a depression diagnosis (aOR=0.40; 95% CI, 0.19–0.85), but increased among Indigenous participants (aOR=1.36; 95% CI, 1.02–1.82).
Anxiety improvement was less likely among women (aOR=0.71; 95% CI, 0.53–0.97), individuals reporting recent injection drug use (aOR=0.61; 95% CI, 0.43–0.84), those experiencing food insecurity (aOR=0.50; 95% CI, 0.31–0.77), and those prioritizing mental health (aOR=0.41; 95% CI, 0.25–0.67).

Cite This Study

Sharma et al. (2026) studied this question.

synapsesocial.com/papers/6a7ec754b70b84ec8b9139ba https://doi.org/10.1186/s12889-026-28803-1

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Implication

Cohort study reveals food insecurity and substance use hinder mental health improvement in marginalized urban residents, highlighting the necessity of structural interventions.

A cohort study examining factors associated with improvement in mental health symptoms among residents of a low-income neighborhood facing multiple axes of marginalization

Discussion

Member takes

Implication

Key Points

Cite This Study

A cohort study examining factors associated with improvement in mental health symptoms among residents of a low-income neighborhood facing multiple axes of marginalization

Discussion

Member takes

Implication

Key Points

Cite This Study

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