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Is Urban Living Bad for Your Mental Health?

The Midtown Manhattan Study showed the link between cities and mental health.

Key points

  • For decades, social scientists have debated whether cities are good or bad for mental health.
  • The Midtown Manhattan Study found that mental illness was common in New York City.
  • It also found that mental illness was more likely to be found where there was social deprivation.
Oto Godfrey/Wikipedia/	 Creative Commons Attribution-Share Alike 3.0 Unported/
New York Times Square
Source: Oto Godfrey/Wikipedia/ Creative Commons Attribution-Share Alike 3.0 Unported/

There is much interest today in the positive effects nature can have on mental health. During the pandemic, people fortunate enough to have access to the countryside, parks, or bodies of water found solace in nature. Seeing deer, foxes, and even bears tentatively explore abandoned urban spaces filled many people with wonder.

Thousands of people began outdoor swimming in Scotland, reaping the mental health benefits. The message seemed clear: For some, nature can do for mental health what psychiatry sometimes cannot.

But what about cities themselves? If nature is good for our mental health, does that mean cities have the opposite effect?

It's a question social scientists have been asking for well over a century. One of the first forays into the subject came from the German sociologist Georg Simmel (1858-1918), who wrote the influential 1903 essay The Metropolis and Mental Life. Simmel argued that city living altered our mental state, not necessarily for good or ill.

Later studies, such as those conducted by the Chicago School of Sociology during the 1920s and 1930s, also explored the topic. These studies focused on social problems that emerged in cities but did not necessarily blame cities themselves for these problems. Instead, they tended to focus on the role of specific socioeconomic factors.

After World War II, social psychiatry studies also addressed the relationship between urban life and mental health. The largest and most influential was the Midtown Manhattan Study, which investigated mental health and illness in white adults between 20 and 59 in the Upper East Side. The project’s findings were published in Mental Health in the Metropolis (1962).

On the surface, the data coming out of midtown did not bode well for cities. The researchers found that only 18.5 percent of their participants were mentally well. Nearly a quarter of them were impaired by mental health problems, unable to work or function socially. Newspapers all over the U.S. picked up on these statistics, questioning whether living in cities like New York was for “nuts only.”

But the devil was in the detail. A different picture emerged when the statistics were broken down according to socioeconomic status. Nearly a third of people of high socioeconomic status were mentally well; 37 percent only had mild symptoms. None were found to be incapacitated.

The situation was very different for people occupying the lower tiers of society. Less than 5 percent of them were deemed to be mentally well. Nearly half (47.3 percent) were impaired by mental illness, and 9.3 percent were incapacitated.

Moreover, studies investigating mental health in rural communities found similar rates and socioeconomic profiles. For instance, the statistics uncovered by the Stirling County Study, which focussed on rural Nova Scotia, effectively mirrored that of Midtown Manhattan. There, too, mental illness was more common where there was poverty, inequality, and social isolation.

Regardless of such findings, the post-WWII period was a time of suburbanization, not urbanization. People—especially white people—left the centers of U.S. cities for the suburbs during these years for a variety of reasons. This depopulation damaged the economy of many urban centers, resulting in more social problems and worse mental health.

So, are cities bad for mental health? That depends largely on the city itself and where you live in it. Suppose you live in a safe, clean, integrated, egalitarian neighborhood with low poverty levels, inequality, and good access to education and economic opportunities. In that case, the answer is likely to be no. But the answer might differ if your neighborhood doesn’t offer these attributes.

It is also worth adding that some people are city mice, and others are country mice. Some people love the bustle and buzz of cities and wouldn’t want to be anywhere else.

Other people relish the quiet that the country may offer. Regardless of where we live, financial security, equality, a sense of community, and social connection are all important for our mental health.


Smith, Matthew. (2023). The First Resort: The History of Social Psychiatry in the United States. New York: Columbia University Press.

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