UC Riverside

Mental health disorders, such as Major Depressive Disorder, depression, and dysthymia, represent a significant public health burden in the United States. However, area-level structural conditions that drive these disparities in mental health outcomes remain understudied at the community level. Limited research has examined the association between the CDC Social Vulnerability Index and area-level mental health outcomes at the Zip Code Tabulation Area level, especially in high-vulnerability regions such as the Inland Empire. This study employed an ecological, cross-sectional secondary data analysis to examine the association between CDC AVI scores and three area-level mental health outcomes (poor mental health days, depression, insufficient sleep) across 168 ZCTAs in the Inland Empire, comprising Riverside and San Bernardino counties. Social vulnerability data were obtained from the American Community Survey, and mental health outcomes were obtained from CDC PLACES Better Health data. Simple and multiple linear regression models were estimated for the overall SVI scores and individual SVI theme scores. Interaction models were examined to determine whether proximity to a college or university modified the association between SVI and mental health among Inland Empire ZCTAs. It was found that SVI scores were significantly associated with poor mental health days and insufficient sleep, but not with depression prevalence. Socioeconomic status was the strongest and most consistent domain-level predictor across all three outcomes. The inverse association between minority status and depression prevalence likely reflects diagnostic access barriers. University proximity did not significantly modify the association between SVI and prevalence of mental health disorders within Inland Empire ZCTAs, but proximity was found to be an independent predictor of mental health outcome, with ZCTAs closer to universities having better mental health outcomes. These findings highlight the importance of upstream socioeconomic interventions and expanded diagnostic access in high-vulnerability regions.