Abstract
Purpose: This study aims to examine perceptions of neighborhood quality and safety before and after the death of Michael Brown and the unrest that followed.Methods: In this secondary analysis of baseline data from one site in The Lifestyle Interventions for Expectant Moms (LIFE-Moms) Consortium, pregnant African American women in the St. Louis region completed a survey of neighborhood perceptions. Logistic regression was used to explore associations between perceptions among those completing baseline surveys and entering the study before and after August 9, 2014 (range: 2012–2015), adjusted for demographic characteristics.Results: Of 267 participants, half (n=134) completed the survey after August 9, 2014. Thirty-four percent of participants completing the survey after this date felt “The crime rate in my neighborhood makes it unsafe to go on walks during the day” compared with 21% of those completing the survey before (adjusted odds ratio=2.0, 95% confidence interval: 1.1–3.7). There were no consistently significant differences in demographic characteristics or in the remaining 16 neighborhood items.Conclusions: This study is an example of how an unexpected shift in the community context in the wake of a profound event may impact health behaviors and outcomes in a measurable way.Clinical Trials Registration: NCT01768793.
Highlights
The discussions of health equity and social determinants of health in the public health literature are more prominent and articulate a critical discourse around the many influences on health and health outcomes.[1,2,3,4] Inequalities in neighborhood environments are hypothesized to drive these health disparities, and direcly impair public health efforts to achieve health equity.[5]
To contribute to the picture of how officer-involved shootings and the resulting unrest may contribute to health, the current study explores baseline data from a large trial investigating an intervention to promote healthy gestational weight gain among African American women with low socioeconomic status in the St
Demographic characteristics for the whole sample and separated based on when the survey was completed are shown in Table 1; no differences were observed between those taking the survey before and those taking the survey after August 9, 2014
Summary
The discussions of health equity and social determinants of health in the public health literature are more prominent and articulate a critical discourse around the many influences on health and health outcomes.[1,2,3,4] Inequalities in neighborhood environments are hypothesized to drive these health disparities, and direcly impair public health efforts to achieve health equity.[5] To ‘‘optimize the conditions in which people are born, grow, live, work, learn and age,’’1 public health research must build an empirical understanding of how environments and environmental social contexts impact individuals and their communities and lead to inequities and disparities. A large body of research reminds us that the everyday manifestation of racism in the environments that individuals traverse takes a toll on the body.[6,7] The relationships between local and neighborhood environments and health outcomes are important components of these determinants.
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