Rethinking Urbanicity: Conceptualizing Neighborhood Effects on Women's Mental Health in Kampala's Urban Slums.

Urbanicity is a recognized determinant of mental health, yet conventional measures such as population density or the rural-urban divide often fail to capture the complex realities of informal settlements in low- and middle-income countries. This paper conceptualizes neighborhood effects through the lived experiences of young women in Kampala, Uganda, drawing on participatory research from the NIH-funded TOPOWA study. Using community mapping and Photovoice, participants identified neighborhood features that shape wellbeing, including sanitation facilities, drainage systems, alcohol outlets, health centers, schools, boda boda stages (motorcycle taxis), lodges, religious institutions, water sources, markets, and recreational spaces. These methods revealed both stressors-poor waste management, flooding, violence, gendered harassment, crime, and alcohol-related harms-and protective resources, including education, places of worship, health centers, social networks, identity, and sports activities. We argue that urbanicity in slum contexts should be understood as a multidimensional construct encompassing deprivation, fragmentation, exclusion, and resilience. This reconceptualization advances conceptual clarity, strengthens the validity of mental health research in low-resource settings, and informs interventions that simultaneously address structural risks and promote community assets. The case of Kampala demonstrates how participatory evidence can reshape the understanding of neighborhood effects with implications, for global mental health research and practice.