Household living conditions and mental health of youth and adults: differences between urban and rural regions

BACKGROUND: Among a broader set of household assets that support healthy living, access to water, a refrigerator, air conditioning, and domestic help may be especially relevant for mental health. However, these components of household living conditions vary substantially across regions and have rarely been examined in relation to mental health. This study examines how these key household living conditions relate to depression and anxiety among children and adolescents (i.e., youth) and adults, while also exploring urban and rural differences in these associations. METHODS: Participants were interviewed in collaboration with the Centre for Monitoring Indian Economy (CMIE) that has been conducting a longitudinal survey covering 98% of India's population. The current analysis is based on mental health data collected in June 2023, including 8,205 households living in rural regions and 19,979 households living in urban regions. These households were composed of 29,188 members in rural regions and 67,351 members in urban regions. Among these household members, 37,453 adults provided information on their own depression and anxiety, and 20,397 adults reported on the depression, and 19,363 on the anxiety of youth living in the household. RESULTS: Overall, having unlimited access to water, a refrigerator, and domestic help was associated with lower depression and anxiety among youth and adults. Specifically, having a refrigerator and domestic help were related to lower depression and anxiety when individuals live in rural settings compared to urban ones, whereas air conditioning and water access were linked to lower depression and anxiety in urban settings. CONCLUSIONS: These findings highlight the connection between these living conditions and mental well-being, suggesting that interventions targeting mental health should be designed with the understanding that less access to water, refrigerator, air conditioning, and domestic help is related to poorer mental health.