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3 Ways That City Living Is Linked with Psychological Illness

New research explores the association between mental health and where you live.

Commuters / Pexels
Source: Commuters / Pexels

For many residents of urban areas around the world, cities represent the promise of a rewarding life that allows them, more than their rural counterparts, to reap the benefits of economic growth, developments in mass transit, and technological innovation. As a byproduct of this progress, however, densely populated metropolitan landscapes pose unique psychological challenges not found in other environments.


Research on urbanicity and mental health shows that a number of disorders are linked with city life, including disorders with psychotic elements (e.g., schizophrenia) and non-psychotic elements (e.g., loneliness and depression). The association between urbanicity and risk of schizophrenia has been documented in multiple studies (Vassos, Pederson, Murray, Collier, & Lewis, 2012; Heinz, Deserno, & Reininghaus, 2013). Greater levels of urbanicity, measured in overall population or density, are correlated with the incidence of schizophrenia. The risk for schizophrenia in the most urban environment is 2.37 times higher than in the most rural environment (Vassos, et al., 2012). Recent research has explored potential mechanisms linking social exclusion in urban environments to psychosis. Evidence suggests that factors such as social fragmentation and deprivation may play direct or indirect roles (Heinz, Deserno, & Reininghaus, 2013).

City Life / Pexels
Source: City Life / Pexels


A meta-analysis of psychiatric disorders in rural vs. urban environments within developed countries found higher rates of mood and anxiety disorders in urbanized areas (Peen, Schoever, Beekman, & Dekker, 2010). Social scientists have known for some time that a lack of social relationships can heighten anxiety. An individual’s chances of sickness or death are doubled for those who are cut off from friendships and family (House, Landis, Umberson, 1988). With a risk factor similar to smoking and obesity in scope, loneliness – which often triggers stress – has been linked to many diseases and, at least among mice, can increase the growth of cancerous tumors (Williams, Pang, Delgado, Kocherginsky, Tretiakova, Krausz, Pan, He, McClintock, & Conzen, 2009). Isolation is so powerful that recalling memories of being snubbed or socially excluded often leads participants to report colder room temperatures than those who were asked to recall happy times with friends (Zhong, & Leonardell, 2008).


Social isolation in cities is a growing epidemic. The percentage of American adults who say they are lonely has doubled since the 1980s from 20 percent to 40 percent (Anderson, 2010). According to a 2013 survey conducted by ComRes on behalf of Radio 2 and BBC Local Radio, 52% of Londoners feel lonely. The growing problem of isolation in cities belies intuitive thinking. Metropolitan areas often regarded as centers of culture and commerce teeming with people who all crave a sense of connectedness. The reality for many is that cities provide an overwhelming sense of anxiety driven in part by the dense crowds of anonymous strangers that are constantly surrounding us. A large cross cultural comparison of rural and urban areas in developed countries found that urban living raises the risk of mood disorders by 39% (Peen, Schoevers, Beekman, & Dekker, 2010). The issue of social isolation in cities is so pressing that programs like Talk to Me and The Loneliness Project were created to take on the problem.

Concerned / Pexels
Source: Concerned / Pexels

The human desire to seek out all varieties of interactions ranging from momentary eye contact to long term intimacy with partners, represents a basic need as fundamental to human nature today as it was to our Pleistocene ancestors. A number of studies point to the psychological effects resulting from the absence of meaningful social interactions. At any given moment, 20% of all people are unhappy because of social isolation (Masi, Chen, Hawkley, & Cacioppo, 2011).

Measureable negative outcomes associated with living in isolation include clinical depression, anxiety disorders, abnormal sensory arousal, and suicide. Given that dynamic evolutionary pressures helped to shape humans in to the most social animal on the planet, it may not be surprising that we can “see” loneliness in the brain. When viewing pleasant and unpleasant pictures, lonely and non-lonely subjects show activation in different brain areas. One of the reward centers of the brain, the ventral striatum, is stimulated by love, food, and other desirables. When non-lonely subjects viewed the pleasant pictures in the experiment they showed more activity in that region of the brain compared to the lonely participants (Cacioppo, Norris, Decety, Monteleone, & Nusbaum, 2009).

Final Note

Together these mental health findings underscore the dual nature of cities – rapid urban growth can be viewed simultaneously as one of the greatest opportunities for humanity and one of the greatest complications. Despite living inside crowded urban areas, residents often feel socially isolated – an emotional state that partially mimics what is seen in prisoners who are intentionally isolated as punishment.


Bennett, K., Gualtieri, T., & Kazmierczyk, B. (2018). Undoing solitary urban design: A review of risk factors and mental health outcomes associated with living in social isolation. Journal of Urban Design and Mental Health, 4, 1-7.

Bennett, K. L. (2004). How to start teaching a tough course: Dry organization vs. excitement on the first day of class. College Teaching, 52, 106.

Bennett, K. L. (2012). Jealousy’s design: Maladaptive trait or psychological solution? Lambert Academic Publishing, ISBN: 978-3-659-21408-0.

Cacioppo, J. T., Norris, C. J., Decety, J., Monteleone, G., & Nusbaum, H. (2009). In the eye of the beholder: Individual differences in perceived social isolation predict regional brain activation to social stimuli. Journal of Cognitive Neuroscience, 21(1), 83-92. 10.1162/jocn.2009.21007

Peen, J., Schoevers, R. A., Beekman, A. T., & Dekker, J. (2010). The current status of urban-rural differences in psychiatric disorders. Acta Psychiatrica Scandinavica, 121(2), 84-93. doi:10.1111/j.1600-0447.2009.01438.x

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