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There is increasing evidence to suggest there is a relationship between a person's neighbourhood environment and determinants of health outcomes, including obesity, diabetes and mental health depression. However, to date, no research in the Kingdom of Saudi Arabia has explored this relationship. We conducted a cross-sectional study to assess neighborhood perceived walkability, aesthetics, safety and connectedness, and their relationship with reported mental health status in the city of Riyadh, Saudi Arabia among Saudi males and females over the age of 18 years. We used validated Arabic versions of the Neighborhood Environment Walkability Scale (NEWS) short form and the (K10) scale. Data were analyzed using descriptive analysis for all study variables. Univariate and multivariate logistic regressions were conducted to estimate the likelihood of depression among the sample. A total of 493 residents in Riyadh-KSA, were included in the study. Most participants in the study responded negatively to statements on neighborhood walkability and aesthetics and did not perceive their neighborhood friendly in terms of providing adequate and accessible footpaths, natural reserves, attractive buildings or well-maintained walkways. Perceptions for walkability and aesthetics were lowest in comparison to safety, access to services and overall neighborhood satisfaction. Older individuals (&amp;gt;40 years) showed increased vulnerability to depression in univariate analysis (OR = 0.78; 95% CI: 0.6241-0.9649) whilst being employed significantly decreased the likelihood of depression by 42%, (OR = 0.58; 95%CI: 0.386-0.875). Perceived neighborhood safety and connectedness were significantly associated with reported depression (OR = 0.930, 95%CI: 0.90-0.962). The results from this study demonstrate an association between neighborhood safety and connectedness with reported depressive symptoms among residents in Riyadh. Further research should focus on whether these observations are in fact causal. Key messages There is an association between perceived neighborhood safety and connectedness with reported depression. This study suggests that walkable built environments may decrease reports of psychological distress, whilst aesthetics and accessibility may improve both physical and mental health.

Perceptions of neighborhood environment on health in a Saudi Population in Kingdom of Saudi Arabia