Housing conditions and mental health in Semnan, Iran: associations with tenure, affordability, housing quality, and neighborhood characteristics

Source abstract

Given the substantial gap between household income and housing costs in Iran, this study analyzes how housing-related and neighborhood factors are associated with mental health outcomes in Semnan, Iran. Data were collected through a cross-sectional household survey of 470 participants between February and May 2024. Mental health was assessed using the General Health Questionnaire (GHQ-28). Associations between housing- and neighborhood-related factors and mental health outcomes were analyzed using ordinal logistic regression models in R, with housing affordability measured using a context-sensitive threshold reflecting local housing expenditure patterns. The results indicate that renters were more likely than homeowners to experience anxiety, depression, and poorer general mental health. Housing affordability was significantly associated with anxiety, somatic symptoms, social dysfunction, and overall mental health, but not with depression. Housing quality showed protective associations with anxiety, somatic symptoms, and general mental health, with housing neatness emerging as a consistent protective factor. Poorer perceived neighborhood quality and higher noise levels were associated with adverse mental health outcomes, while decoration and access to daily services were uniquely associated with depression. Overall, the findings highlight the importance of integrated housing and neighborhood policies to promote urban mental health in middle-income contexts such as Iran.