Why cities matter for adolescent mental health and wellbeing

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Being an adolescent in a rapidly urbanising world is challenging. Urban living, as compared with rural living, is associated with a higher risk of poor mental health outcomes, such as depression, anxiety, and some psychotic disorders, along with an increased risk of concentrated poverty, low social capital, social segregation, and other social and environmental adversities. These early mental health challenges have long-term effects on social disability and other adverse economic outcomes in adulthood.

However, urbanisation, defined by population growth, spatial expansion, and the concentration of people in cities, also generates opportunities for adolescents to more easily access economic opportunities, foster interpersonal connections, engage in placemaking, and construct personal identities—all of which are linked to improved health and wellbeing.

Cities exemplify the ways that determinants over multiple levels, including environmental (eg, high levels of violent crime, and lack of green and blue spaces), social (eg, social alienation), and inner or individual (eg, psychological risk factors), can shape mental wellbeing. This is why cities are also a setting where it is crucial that action to improve mental health is expanded beyond narrowly defined so-called mental health promotion.

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