Influence Of Neighborhood Factors Research Articles

Perceived Neighborhood Disorder, Social Cohesion, and Depressive Symptoms among Spousal Caregivers

Most prior research on caregivers’ mental health focused on individual or household factors, we know much less about the influence of neighborhood factors on mental health of spousal caregivers. The current study fills the gap in our knowledge by examining the association of neighborhood characteristics (i.e., perceived neighborhood disorder and neighborhood social cohesion) and depressive symptoms among spousal caregivers. We used data from 2006 to 2016 waves of the Health and Retirement Study, which includes 2,362 spousal caregivers. Negative binomial regression models were estimated to examine the association of perceived neighborhood disorder and neighborhood social cohesion with depressive symptoms. A greater perceived neighborhood disorder was associated with higher CES-D scores, which indicates more depressive symptoms. On the other hand, a higher level of neighborhood social cohesion was associated with lower CES-D scores. When they were included in the same model, the association between neighborhood disorder and depression disappeared, while respondents who reported higher levels of neighborhood social cohesion continue to exhibit lower CES-D scores than those lived in less cohesive neighborhoods. This study highlights the importance of neighborhood contexts in understanding caregivers’ well-being. Findings of this study suggest that neighborhood social cohesion may attenuate the negative effects of neighborhood disorder. Therefore, enhancing positive characteristics of the neighborhood may promote well-being of spousal caregivers.

Perceived Neighborhood Disorder, Social Cohesion, and Depressive Symptoms among Spousal Caregivers

Although individual sleep characteristics are related to frailty, these characteristics do not occur separately. A multidimensional measure of sleep might provide a better estimation of frailty compared to isolated sleep characteristics. This study investigated the association of a multidimensional measure of sleep health with frailty and examined whether such relationship differed by sex. Data were from the Taiwan Longitudinal Study on Aging (2011), a survey with a nationally representative sample of Taiwanese older adults (N=2,015). Frailty was defined using the Fried-criteria. Self-reported sleep during the past month was used to conceptualize the five sleep health dimensions in the SATED model (satisfaction-alertness-timing-efficiency-duration; higher scores representing better sleep health). Their relationship was estimated using logistic regression analysis adjusting for sociodemographic (age, sex, education), health (chronic conditions, cognitive function, pain, depressive symptoms [excluding items overlapping with frailty and sleep]), and lifestyle (drinking, smoking, exercise) characteristics. The results showed that having a better sleep health composite score was significantly related to lower odds of being frail in both sexes adjusting for sociodemographic information. Such effect remained significant among females but not males after adding health and lifestyle characteristics to the models. Sleep satisfaction and daytime alertness in both sexes and sleep duration among females were significantly associated with frailty adjusting for sociodemographic information. Only alertness among males was significantly related to frailty in model with all covariates. Our findings show that having a better sleep health across multiple dimensions is related to a lower risk of being frail, and the association differs by sex.

The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors

BackgroundAA living in rural areas of the southeastern U.S. experience a disproportionate burden of cardiovascular disease (CVD) morbidity and mortality. Neighborhood environmental factors contribute to this disparity and may decrease the effectiveness of lifestyle interventions aimed at preventing CVD. Furthermore, the influence of neighborhood factors on AA CVD risk behaviors (i.e. physical activity) may be obscured by the use of researcher-defined neighborhoods and researcher-defined healthy and unhealthy places. The objective of this study was to elucidate the effects of neighborhood environments on AA CVD risk behaviors among AA adults who recently completed a lifestyle intervention. We specifically sought to identify AA adults’ self-perceived places of significance and their perceptions of how these places impact CVD risk behaviors including diet, physical activity and smoking.MethodsWe conducted semi-structured interviews with AA adults (N = 26) living in two rural North Carolina counties (Edgecombe and Nash, North Carolina, USA). Participants were recruited from a community-based behavioral CVD risk reduction intervention. All had at least one risk factor for CVD. Participants identified significant places including where they spent the most time, meaningful places, and healthy and unhealthy places on local maps. Using these maps as a reference, participants described the impact of each location on their CVD risk behaviors. Data were transcribed verbatim and coded using NVivo 12.ResultsThe average age of participants was 63 (SD = 10) and 92% were female. Places participants defined as meaningful and places where they spent the most time included churches and relatives’ homes. Healthy places included gyms and parks. Unhealthy places included fast food restaurants and relatives’ homes where unhealthy food was served. Place influenced CVD risk behaviors in multiple ways including through degree of perceived control over the environment, emotional attachment and loneliness, caretaking responsibilities, social pressures and social support.ConclusionsAs we seek to improve cardiovascular interventions for rural AA in the American South, it will be important to further assess the effect of significant places beyond place of residence. Strategies which leverage or modify behavioral influences within person-defined significant places may improve the reach and effectiveness of behavioral lifestyle interventions.

Influence of Neighborhood Factors on Sleep in Home Dwelling Multiethnic Older Adults With Dementia

Current scientific paradigms inadequately capture complex clinical, behavioral, and sociocultural factors impacting health and well-being in persons living with dementia (PLWD). The purpose of this study was to identify differences in individual and neighborhood-level factors contributing to sleep among multi-ethnic PLWD. Wrist actigraphy measured objective sleep characteristics. Subjective sleep was assessed using the PROMIS sleep measure. GIS mapping analyzed neighborhood-level factors (walkability, green space, crime index, density). Walkability was significantly associated with subjective sleep (p.006) controlling for age and dementia stage. Number of night awakenings was significantly associated with density, crime and housing value (p<.001). PLWD in neighborhoods with higher population density, annual crime, low median home and low walkability would benefit from interventions targeting unsupportive neighborhood environments to improve sleep.

The influence of neighborhood factors on biological measures of stress in home‐dwelling multi‐ethnic older adults with dementia

AbstractBackgroundRecently researchers have begun to examine the possible biological pathways through which neighborhood context may affect the health of vulnerable residents. Although stress is often hypothesized to contribute to the effects of neighborhoods on health, no studies have investigated associations of neighborhood characteristics and stress biomarkers in home dwelling persons living with dementia (PLwD). Identifying these biological pathways is fundamental to increasing our understanding of how neighborhoods can influence health and well being in vulnerable residents including those with dementia.MethodsGuided by the National Institute on Minority Health and Health Disparities Framework, this pilot study examined pathways linking both micro (individual level) and macro (neighborhood) level factors in home dwelling PLwD. The model was used to determine what community level factors (density, total crime index, median home value, and noise index) were associated with measures of salivary cortisol controlling for sociodemographics, dementia stage, and comorbid illnesses. The sample included 100 participants: 30 Whites, 39 African Americans, and 31 Latinos with an average age of 73.6. Saliva samples were collected using Salivette collection tubes over two days and stored at −20 °C until analysis.ResultsResidents of neighborhoods with lower housing value and higher noise and density were disproportionately composed of racial/ethnic minorities (with the patterning for Hispanics more pronounced than for blacks.) Significantly lower levels of cortisol at wakeup and a less steep decline was associated with adverse neighborhood environments (higher noise, crime, density, and lower housing value). The strongest relationship between neighborhood characteristics and cortisol levels was found for neighborhood crime. Individuals with dementia residing in higher crime neighborhoods had significant lower levels of cortisol at wakeup and with less pronounced initial declines than those residing in low crime neighborhoods.ConclusionGiven that lower cortisol at wakening and slower rate of decline in cortisol across the day are associated with adverse health outcomes, our analyses can inform the identification of risky communities that are most likely to benefit from health‐supportive community interventions to minimize the negative impacts of unsupportive community environment. These pilot results suggest that further investigation of the effects of neighborhood contexts on stress biomarkers and health outcomes in PLwD is warranted.

Abstract B039: The impact of social and built environments on quality of life among cancer survivors

Abstract Background: With over 16 million cancer survivors in the U.S., understanding factors that improve health-related quality of life (HRQOL) after cancer diagnosis is critical. Previous studies have identified demographic, clinical and behavioral factors that shape HRQOL among cancer patients and have observed poorer HRQOL among racial/ethnic minorities, individuals of low socioeconomic status (SES), or those with comorbidities. Few studies have considered the influence of neighborhood factors (census block group SES (nSES), census tract poverty, county segregation) on HRQOL. Thus, we proposed to assess racial/ethnic disparities in HRQOL and evaluate the extent to which these disparities are explained by neighborhood factors. Methods: We pooled data on 2,500 diverse (i.e., multiethnic, varied SES, multiple cancer sites) cancer survivors from three population-based cancer survivorship studies in California and linked them to the California Neighborhoods Data System. Separately for the two continuous HRQOL outcomes (physical and mental composite scores, PCS and MCS, from SF36), using a 3-level model with participants nested within block groups, which are nested within study/region, we calculated least squares means and parameter estimates for each racial/ethnic group, with and without adjustment for covariates. Predisposing factors included age, gender, education, employment, income, health insurance status, marital status and significant clinical and tumor characteristics. Health behaviors included physical activity and body mass index. Results: Among 2,477 cancer survivors, we observed racial/ethnic disparities in HRQOL, with African Americans reporting the lowest (worst) PCS (42.7), Latinos reporting the lowest MCS (48.4) and Asians/Pacific Islanders reporting the highest scores (PCS: 45.4; MCS: 51.1) in unadjusted models. In models adjusted for age and cancer recurrence (and stage for PCS), both PCS and MCS increased with higher nSES. Assessed separately, the following neighborhood factors were associated with decreased MCS after adjusting for nSES: higher population density, street connectivity (gamma), % renting, % non-single-family units, more parks, and restaurant index (more unhealthy). No other neighborhood factor was associated with PCS after adjusting for nSES. Compared to non-Hispanic (NH) Whites, African American disparities in PCS were fully attenuated after adjusting for nSES. Similarly adjusting for neighborhood factors fully attenuated Hispanic disparities in MCS. For PCS, adjusting for predisposing, nSES, and/or behavioral factors resulted in Hispanics having better HRQOL compared to NH Whites. Conclusions: Among a diverse cohort of cancer survivors, neighborhood attributes were associated with HRQOL. Racial/ethnic disparities in HRQOL were attenuated with inclusion of neighborhood factors in the models. Elucidating the pathways through which these neighborhood attributes impact HRQOL will be important to improving survivorship outcomes. Citation Format: Salma Shariff-Marco, Alison J. Canchola, Theresa H.M. Keegan, Alyssa Nickell, Ingrid Oakley-Girvan, Ann S. Hamilton, Scarlett L. Gomez. The impact of social and built environments on quality of life among cancer survivors [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B039.

Neighborhood factors and six-month weight change among overweight individuals in a weight loss intervention.

The purpose of this study was to examine the neighborhood environment and the association with weight change among overweight/obese individuals in the first six months of a 12-month weight loss intervention, EMPOWER, from 2011 to 2015. Measures of the neighborhood environment included neighborhood racial composition, neighborhood income, and neighborhood food retail stores density (e.g., grocery stores). Weight was measured at baseline and 6 months and calculated as the percent weight change from baseline to 6 months. The analytic sample (N = 127) was 91% female and 81% white with a mean age of 51 (± 10.4) years. At 6 months, the mean weight loss was 8.0 kg (± 5.7), which was equivalent to 8.8% (± 6%) of baseline weight. Participants living in neighborhoods in which 25–75% of the residents identified as black had the greatest percentage of weight loss compared to those living in neighborhoods with < 25% or > 75% black residents. No other neighborhood measures were associated with weight loss. Future studies testing individual-level behavioral weight loss interventions need to consider the influence of neighborhood factors, and how neighborhood-level interventions could be enhanced with individual-level interventions that address behaviors and lifestyle changes.

Intelligence-led policing: a comparative analysis of community context influencing innovation uptake

The capacity of police organisations to adopt innovative practices is poorly understood. This paper examines the relative uptake of one particular innovation: intelligence-led policing (ILP), across four police areas in New Zealand. We used a survey of 286 officers and 32 depth interviews to explore police attitudes and perceptions of community context influencing the adoption of ILP. We found strong uptake of ILP was associated with a healthy relationship with local government and officer perceptions of more manageable demand for police services and perceptions of less complex and more stable operational environments. Strong uptake of ILP also mitigated the influence of neighbourhood factors on officer behaviour. Media relations, police unions and community relations did not influence or impair the uptake of ILP. In police areas where ILP uptake was patchy, officers tended to view their operational environment as more unstable and complex and were more influenced by neighbourhood factors. The uptake of ILP equipped officers with greater self-belief about their ability to influence the local criminal environment.

The influence of neighborhood factors on the quality of life of older adults attending New York City senior centers: results from the Health Indicators Project

To examine the association between self-assessed quality of life (QOL) and perceived neighborhood safety, social cohesion, and walkability among older adults in New York City (NYC). We used data from the 2008 Health Indicators Project, a cross-sectional survey of 1,870 older adults attending 56 NYC senior centers. QOL, a binary measure, was created by dichotomizing a 5-point Likert-scaled global assessment. Neighborhood safety, social cohesion, and walkability were multi-component scale variables that were standardized due to varying response metrics. Multivariate binomial logistic regression analysis was performed on 1,660 participants with complete data. After adjusting for covariates, QOL was significantly associated with neighborhood safety and social cohesion. A one-standard deviation increase in neighborhood safety and social cohesion increased the log odds of having higher QOL by 30% (odds ratio (OR)=1.30; 95% confidence interval (CI)=1.14, 1.48; P≤0.001) and 36% (OR=1.36; 95% CI=1.16, 1.59; P≤0.001), respectively. Higher QOL was not significantly associated with neighborhood walkability. The results of this study underscore the need for initiatives that focus on enhancing age-friendly neighborhood features in large urban centers such as NYC and beyond.