Neighborhood Opportunity and Mental Health–Related Hospitalization Rates Among Children and Youths in 12 U.S. States

OBJECTIVE: Using the Child Opportunity Index (COI) 3.0 and mental health-related hospitalization rates among children and youths, the authors examined whether hospitalization rates were significantly associated with neighborhood conditions. METHODS: . Hospitalization rates were estimated overall, by state, and by 10 psychiatric diagnosis categories. Differences across COI quintiles were examined with negative binomial regression models. RESULTS: Among 21,156,318 children and youths, 157,641 were hospitalized for mental health problems, corresponding to an incidence rate of 74.5 per 10,000 population. The hospitalization rate (per 10,000 children and youths) was highest in the very low-COI quintile (incidence rate=76.9, 95% CI=73.4-80.5) and lowest in the very high-COI quintile (incidence rate=67.3, 95% CI=64.8-69.9). Trends were consistent within psychiatric diagnosis categories, except for anxiety disorders, which showed a positive correlation between COI level and hospitalization rates. Hospitalization rates varied significantly among states (ranging from 34 to 135 per 10,000 youths, in Oregon and Kentucky, respectively). CONCLUSIONS: Children and youths residing in lower-opportunity neighborhoods had higher mental health-related hospitalization rates, which varied by state and psychiatric diagnosis. Future research to understand the reasons for these variations across COI levels could inform programs to avoid mental health-related hospitalizations.