Date of Conferral

10-21-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Tolulope Osoba

Abstract

Child and adolescent mental health problems are increasing, creating a critical public health concern. Both neighborhood disadvantage and excessive screen use have been implicated as risk factors, yet their interplay remains underexplored. This study investigated whether screen time mediates the relationship between neighborhood conditions and mental health outcomes in U.S. youth. Grounded in Bronfenbrenner’s ecological systems theory, the study addressed three questions: (a) Do neighborhood conditions predict youth mental health outcomes? (b) Is screen time associated with these outcomes? (c) Does screen time mediate the neighborhood–mental health relationship? A cross-sectional secondary analysis of the 2018–2019 National Survey of Children’s Health (N = 43,213) was conducted. Logistic regression models estimated associations between neighborhood quality, screen time, and youth anxiety and depression, controlling for sociodemographics. Mediation was tested with the Hayes PROCESS macro using 5,000 bootstrap samples. Neighborhood disadvantage was linked to higher odds of adverse mental health (OR = 1.27, 95% CI [1.18, 1.37]). Greater screen use was also associated with increased risk (OR = 1.15, 95% CI [1.08, 1.23]). Mediation analysis suggested that screen time partially accounted for the neighborhood–mental health relationship, although indirect effects were small. The results suggest the interconnection of community context and behavioral factors in shaping mental health risk. Implications for positive social change may include policies and community initiatives that improve neighborhood conditions and promote balanced screen use to reduce inequities in youth mental health.

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Available for download on Wednesday, October 28, 2026

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