Neighborhood Physical Environment Research Articles

Neighborhood physical environments and change in cardiometabolic risk factors over 14 years in the study of Women's health across the nation

BackgroundNeighborhood physical environments may influence cardiometabolic health, but prior studies have been inconsistent, and few included long follow-up periods. MethodsChanges in cardiometabolic risk factors were measured for up to 14 years in 2830 midlife women in the Study of Women's Health Across the Nation, a multi-ethnic/racial cohort of women from seven U.S. sites. Data on neighborhood food retail environments (modified Retail Food Environment Index) and walkability (National Walkability Index) were obtained for each woman's residence at each follow-up. Data on neighborhood access to green space, parks, and supermarkets were available for subsets (32–42%) of women. Models tested whether rates of change in cardiometabolic outcomes differed based on neighborhood characteristics, independent of sociodemographic and health-related covariates. ResultsLiving in more (vs. less) walkable neighborhoods was associated with favorable changes in blood pressure outcomes (SBP: −0.27 mmHg/year, p = 0.002; DBP: −0.22 mmHg/year, p < 0.0001; hypertension status: ratio of ORs = 0.79, p < 0.0001), and small declines in waist circumference (−0.09 cm/year, p = 0.03). Small-magnitude associations were also observed between low park access and greater increases in blood pressure outcomes (SBP: 0.37 mmHg/year, p = 0.003; DBP: 0.15 mmHg/year, p = 0.04; hypertension status: ratio of ORs = 1.16, p = .04), though associations involving DBP and hypertension were only present after adjustment for sociodemographic variables. Other associations were statistically unreliable or contrary to hypotheses. ConclusionNeighborhood walkability may have a meaningful influence on trajectories of blood pressure outcomes in women from midlife to early older adulthood, suggesting the need to better understand how individuals interact with their neighborhood environments in pursuit of cardiometabolic health.

Sustainability outcomes and policy implications: Evaluating China's "old urban neighborhood renewal" experiment.

Globally, old urban neighborhood transformation has become a new urban sustainability focus for its significant contribution to the United Nation's Sustainable Development Goal 11. A regeneration-oriented approach is particularly important for Chinese cities with a dwindling land supply, obsoleting infrastructure, and inadequate standard of living. Using a mixed-methods approach informed by BREEAM Communities, we examined two Chinese initiatives-old urban neighborhood renewal (OUNR) and sponge city development (SCD)-through a comprehensive study of pilot project sustainability, policy emphases and gaps, and broader governance implications. We found that SCD's top-down technocratic management was highly efficient in enhancing neighborhood hydrological functions and physical environment. However, successes were undermined by the lack of climate considerations and civic participation. Besides actionable recommendations for applied scholarship and policymaking in China, we provide insight into how the OUNR/SCD initiatives may broadly inform worldwide urban regeneration practices through project and policy experimentations that build adaptive capacity.

Features of the Physical and Social Neighborhood Environment and Neighborhood-Level Alzheimer's Disease and Related Dementia in South Carolina.

Studies are increasingly examining the relationship between the neighborhood environment and cognitive decline; yet, few have investigated associations between multiple neighborhood features and Alzheimer's disease and related dementias (ADRD). We investigated the relationship between neighborhood features and ADRD cumulative incidence from 2010 to 2014 in the South Carolina Alzheimer's Disease Registry (SCADR). Diagnosed ADRD cases of age were ascertained from the SCADR by ZIP code and census tract. Neighborhood features from multiple secondary sources included poverty, air pollution [particulate matter with a diameter of 2.5 micrometers or less ()], and rurality at the census-tract level and access to healthy food, recreation facilities, and diabetes screening at the county level. In addition to using Poisson generalized linear regression to estimate ADRD incident rate ratios (IRR) with 95% confidence intervals (CIs), we applied integrated nested Laplace approximations and stochastic partial differential equations (INLA-SPDE) to address disparate spatial scales. We estimated associations between neighborhood features and ADRD cumulative incidence. The average annual ADRD cumulative incidence was 690 per 100,000 people per census tract (95% CI: 660, 710). The analysis was limited to 98% of census tracts with a population old (i.e., 1,081 of 1,103). The average percent of families living below the federal poverty line per census tract was 18.8%, and of census tracts were considered rural. The average percent of households with limited access to healthy food was 6.4%. In adjusted models, every ) increase of was associated with 65% higher ADRD cumulative incidence (; 95% CI: 1.30, 2.09), where at or below is considered healthy. Compared to large urban census tracts, rural and small urban tracts had 10% (; 95% CI: 1.00, 1.23) and 5% (; 95% CI: 0.96, 1.16) higher ADRD, respectively. For every percent increase of the county population with limited access to healthy food, ADRD was 2% higher (; 95% CI: 1.01, 1.04). Neighborhood environment features, such as higher air pollution levels, were associated with higher neighborhood ADRD incidence. The INLA-SPDE method could have broad applicability to data collected across disparate spatial scales. https://doi.org/10.1289/EHP13183.

IMPORTANT COMMUNITY FEATURES AND SERVICES IN DIVERSE OLDER ADULTS

Abstract Many cities and towns have tried to create neighborhood environments favorable to older adults. However, it raises the question of whether community aging initiatives reflect the diverse needs of older adults. This study examined how much different types of neighborhood physical and social environments were essential to the life of diverse older adults. This study used data from the 2018 AARP Home and Community Preferences Survey with 762 adults aged 50 and older in the USA (female: 50%; White: 70%, Black: 17%, Hispanic: 12%, other race: 5%). The outcome variables were participants’ rates on the relative importance of seven community features (i.e., outdoor space, housing, transportation, street, social participation, civic engagement, and job). We ran multiple regression analyses to examine the relationships between the importance rating of community features and diverse older populations. Women thought all community features were important in their daily life compared to men, except for transportation. Black and Hispanic older adults valued all seven community features more highly than White older adults. People with disabilities thought housing and civic engagement were essential daily; people who experienced loneliness thought housing, transportation, social participation, and civic engagement were important. This study adds to the growing literature on identifying the diverse needs of older adults in developing and creating age-friendly environments. Community features and services were essential to women and racial and ethnic minority adults. Depending on older adults’ demographic and health-related characteristics, policymakers and practitioners should develop a plan to reflect the diverse needs of older adults.

Pediatric obesity during COVID-19: the role of neighborhood social vulnerability and collective efficacy.

Childhood obesity increased in the first year of COVID-19 with significant disparities across race, ethnicity, and socioeconomic status. Social distancing led to fewer physical activity opportunities but increased screen time and high-calorie food consumption, all co-determined by neighborhood environments. This study aimed to test the moderation effects of neighborhood socioeconomic and built environments on obesity change during COVID-19. Using electronic health records from a large pediatric primary care network in 2018-2022, we cross-sectionally examined 163,042 well visits of 2-17-year-olds living in Philadelphia County in order to examine (1) the pandemic's effect on obesity prevalence and (2) moderation by census-tract-level neighborhood socioeconomic disadvantage, crime, food and physical activity-related environments using interrupted-time-series analysis, Poisson regression, and logistic regression. Weekly obesity prevalence increased by 4.9 percent points (pp) during the pandemic (January 2021-August 2022) compared to pre-pandemic (March 2018-March 2020) levels. This increase was pronounced across all age groups, racially/ethnically minoritized groups, and insurance types (ranging from 2.0 to 6.4 pp) except the Non-Hispanic-white group. The increase in obesity among children racially/ethnically minoritized groups was significantly larger in the neighborhoods with high social vulnerability (3.3 pp difference between high and low groups), and low collective efficacy (2.0 pp difference between high and low groups) after adjusting for age, sex, and insurance type. Racially/ethnically minoritized children experienced larger obesity increases during the pandemic, especially those in socioeconomically disadvantaged neighborhoods. However, the buffering effect of community collective efficacy on the disparities underscores the importance of environments in pediatric health.

Assessing bidirectional longitudinal associations between changes in social network structures and cognitive decline in late life

AbstractBackgroundThe role of social networks in maintaining cognitive health is unclear, in part because few longitudinal studies have explored bidirectional associations between changes in social network structures and cognition.MethodSecondary analyses of data collected during nine waves of the National Health and Aging Trends Study (NHATS; 2011‐2019) were conducted. Global cognition was the main outcome, but domain‐specific analyses examined episodic memory, orientation, and executive function. Linear mixed models were used to investigate longitudinal effects of neighborhood social cohesion and physical environment on cognitive decline. Dual‐outcomes models were used to examine bidirectional associations between social network structures and cognitive decline. Covariates included socioeconomic status, physical measurements, mental health, and lifestyle indicators.ResultEligible participants (N = 7,325) were recruited at baseline and followed for an average of 4.86±3.22 years. Bivariate correlations indicated that slopes of changes in social networks or participation and cognitive decline were positively correlated. Having more friend ties and a higher percentage of college graduates at baseline were associated with slower declines in global cognition and episodic memory, whereas higher global cognition at baseline was associated with smaller changes in social network size. Less disorientation at baseline was associated with a slower decline in social participation.ConclusionFindings indicate bidirectional longitudinal relationships between social network structure and cognitive decline. Social networks may improve cognitive health but are also vulnerable to cognitive decline related to disorientation.

Neighborhood Factors, Individual Stressors, and Cardiovascular Health Among Black and White Adults in the US

Chronic stress has been posited to contribute to racial disparities in cardiovascular health. Investigation of whether neighborhood- and individual-level stressors mediate this disparity is needed. To examine whether racial differences in ideal cardiovascular health (ICH) are attenuated by experiences with neighborhood- and individual-level stressors within a racially and geographically diverse population sample. This cross-sectional study examined data from 7720 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study who completed the second in-home visit (2013-2016). The REGARDS study is a population-based, longitudinal study of 30 239 non-Hispanic Black and non-Hispanic White adults aged 45 years or older at baseline (2003-2007). Data for the present study were analyzed from June to July 2021 and in March 2022. Neighborhood physical environment (eg, excessive noise, violence; scored from 7-28, with higher scores indicating more problems), neighborhood safety (scored as very safe, safe, or not safe), neighborhood social cohesion (eg, shared values; scored from 5-25, with higher scores indicating higher cohesion), perceived stress (eg, coping; scored from 0-16, with higher scores indicating greater perceived stress), and the experience of discrimination (yes or no). Ideal cardiovascular health (ICH), measured as a composite of 4 health behaviors (cigarette smoking, diet, physical activity, body mass index) and 3 health factors (blood pressure, cholesterol, and glucose levels). The sample included 7720 participants (mean [SD] age, 71.9 [8.3] years; 4390 women [56.9%]; 2074 Black participants [26.9%]; and 5646 White participants [73.1%]). Black participants compared with White participants reported higher perceived stress (mean [SD] score, 3.2 [2.8] vs 2.8 [2.7]) and more often reported discrimination (77.0% vs 24.0%). Black participants also reported poorer neighborhood physical environment (mean [SD] score, 11.2 [3.8] vs 9.8 [2.9]) and social cohesion (mean [SD] score, 15.5 [2.0] vs 15.7 [1.9]) and more often reported their neighborhoods were unsafe (54.7% vs 24.3%). The odds of having a high total ICH score (ie, closer to ideal) were lower for Black adults compared with White adults, both overall (adjusted odds ratio [AOR], 0.53; 95% CI, 0.45-0.61) and by gender (men: AOR, 0.73 [95% CI, 0.57-0.93]; women: AOR, 0.45 [95% CI, 0.37-0.54]). In mediation analyses, the racial disparity in total ICH score was attenuated by neighborhood physical environment (5.14%), neighborhood safety (6.27%), neighborhood social cohesion (1.41%), and discrimination (11.01%). In stratified analyses, the factors that most attenuated the racial disparity in total ICH scores were neighborhood safety among men (12.32%) and discrimination among women (14.37%). Perceived stress did not attenuate the racial disparity in total ICH scores. In this cross-sectional study of Black and White US adults aged 45 years and older, neighborhood-level factors, including safety and physical and social environments, and individual-level factors, including discrimination, attenuated racial disparities in cardiovascular health. Interventional approaches to improve ICH that separately target neighborhood context and discrimination by gender and race are warranted.

Changes in neighborhood physical and social environments matter for change in mental health: Longitudinal evidence from Dutch panel data

Numerous neighborhood environments have been recognized to affect mental health, but only a few longitudinal studies investigated these associations jointly and whether different population groups are affected differently. We used three-wave panel data of 2699 adults between 2010 and 2016 in the Netherlands to assess the associations between changes in neighborhood physical and social environments and mental health changes. Further, we assessed possible effect modification of gender and income. Mental health was measured using the Mental Health Inventory. Time-varying exposure to green space, blue space, population density, air pollution, socioeconomic deprivation, and social fragmentation were assigned based on individuals' neighborhood histories. Fixed-effect regressions were conducted to assess within-person associations between single and multiple exposures on mental health for the entire sample and stratified by gender and income. Our single-exposure models showed that increases in blue space were significantly associated with mental health improvements, while increases in fine particulate matter (PM2.5) resulted in declines in mental health. These associations were not attenuated in the multi-exposure model. We observed no significant associations for the remaining environments. Stratification analyses showed that females’ mental health further declined as PM2.5 concentrations increased compared to males. Increasing levels of socioeconomic deprivation were associated with further declines in mental health among the less well-off compared with higher-income earners. Our longitudinal findings suggested that neighborhood physical and social environment changes were associated with mental health changes. Future research is required to establish the underlying pathways.

Development and reliability testing of an audit toolbox for the assessment of the physical activity friendliness of urban and rural environments in Germany.

According to socio-ecological theories, physical activity behaviors are linked to the physical and social neighborhood environment. Reliable and contextually adapted instruments are needed to assess environmental characteristics related to physical activity. This work aims to develop an audit toolbox adapted to the German context, to urban and rural settings, for different population groups, and different types of physical activity; and to evaluate its inter-rater reliability. We conducted a systematic literature search to collect existing audit tools and to identify the latest evidence of environmental factors influencing physical activity in general, as well as in German populations. The results guided the construction of a category system for the toolbox. Items were assigned to the categories based on their relevance to physical activity and to the German context as well as their comprehensibility. We piloted the toolbox in different urban and rural areas (100 street segments, 15 parks, and 21 playgrounds) and calculated inter-rater reliability by Cohen's Kappa. The audit toolbox comprises a basic streetscape audit with seven categories (land use and destinations, traffic safety, pedestrian infrastructure, cycling infrastructure, attractiveness, social environment, and subjective assessment), as well as supplementary tools for children and adolescents, seniors and people with impaired mobility, parks and public open spaces, playgrounds, and rural areas. 76 % of all included items had moderate, substantial, or almost perfect inter-rater reliability (κ > 0.4). The audit toolbox is an innovative and reliable instrument for the assessment of the physical activity friendliness of urban and rural environments in Germany.

Association of Perceived Neighborhood Environments With Cognitive Function in Older Adults.

The current study examined the associations between perceptions of the social and physical neighborhood environments and cognitive function in older adults. This cross-sectional study analyzed 821 adults aged ≥65 years from the Adult Changes in Thought study. Perceived neighborhood attributes were measured by the Physical Activity Neighborhood Environment Scale. Cognitive function was assessed using the Cognitive Ability Screening Instrument. The associations were tested using multivariate linear regression. One point greater perceived access to public transit was associated with 0.56 points greater cognitive function score (95% confidence interval [CI] [0.25, 0.88]), and an additional one point of perceived sidewalk coverage was related to 0.22 points higher cognitive function score (95% CI [0.00, 0.45]) after controlling for sociodemographic factors. The perception of neighborhood attributes alongside physical infrastructure may play an important role in supporting older adults' cognitive function. [Journal of Gerontological Nursing, 49(8), 35-41.].

Neighbourhood physical environment influences on children’s outdoor play: a systematic review

Children’s access to outdoor activities is restricted due to the continuous spread of urbanisation in public spaces. Therefore, figuring out how to improve outdoor physical space within the existing environment is becoming increasingly important. This study conducted a systematic review of 55 studies using PRISMA method to examine the link between the physical settings in neighbourhoods and children’s outdoor play. Through Scopus databases to provide a complete list of journal articles based on stringent inclusion and exclusion standards. Identify the gaps by categorising the significant themes and aspects influencing children’s play area requirements. Studies show that the physical environment of a neighbourhood is affected by several social factors besides the needs and preferences of children’s games. It was also found that the most commonly used research methods in children’s play spaces were survey and interview, and the Affordance Theory was widely used as a research framework. This research provides new design possibilities for children’s play areas in residential neighbourhoods. These guidelines emphasise games with varied spatial qualities, the integration of spatial functions, the additional support requirements of parents for children’s play, and the flexibility of children to utilise outside space. Consequently, this analysis identifies knowledge gaps and suggests research directions for future studies.

Abstract 370: Corticosterone-mediated Associations Between Neighborhood Environment Perceptions and Lysosomal Acid Lipase Levels - Data From The Washington, D.C. Cardiovascular Health and Needs Assessment

Experiences of adverse social determinants of health (SDoH), like less favorable neighborhood environment perceptions, are associated with cardiovascular disease (CVD). Lysosomal acid lipase (LAL) plays an important role in lipid metabolism, and genetic LAL deficiency has been linked to CVD risk. We aimed to determine the potential relationship between neighborhood perceptions and LAL and to evaluate stress-related biomarkers as mediators of this relationship in the D.C. Cardiovascular Health and Needs Assessment cohort (60 African American participants, mean age 61yr, 93% female), biomarkers were measured using ELISA, and perceptions of neighborhood violence, physical and social environment, social cohesion, and safety were determined using validated questionnaires with higher scores indicating more favorable perceptions. We explored neighborhood perceptions-LAL relationships with regression models adjusted for BMI and ASCVD risk score and stratified by hyperlipidemia due to the potential confounding role of LDL. Mediation analysis was used to evaluate cortisol and corticosterone as potential mediators of the neighborhood perceptions-LAL relationship. Of the neighborhood perceptions measured, more favorable perceptions of physical and social environment associated with greater LAL (β=0.23, p=0.09); this association persisted only among participants without hyperlipidemia (β=0.42, p=0.04). Only corticosterone associated with both perceived physical and social environment and LAL (Figure); corticosterone mediated 73.1% of this relationship in all participants and 89.9% of this relationship in participants without hyperlipidemia. Our data highlight the relationship between perceived physical and social environment and LAL mediated by corticosterone. Results also emphasize the importance of future interdisciplinary work to better understand mechanisms by which SDoH and associated biomarkers contribute to CVD disparities.

Neighborhood Physical and Social Environments and Social Inequalities in Health in Older Adolescents and Young Adults: A Scoping Review.

Poor health and well-being are prevalent among young people. Neighborhoods may play a role in promoting good health. Little is known on if and how neighborhood characteristics affect health, and social inequalities therein, among young people. In this scoping review, we asked: (1) what features of the neighborhood physical and social environments have been studied in association with the physical and mental health and well-being of young people 15 to 30 years old; and (2) to what extent have social differentials in these associations been studied, and how? We identified peer-reviewed articles (2000 to 2023) through database and snowball searches. We summarized study characteristics, exposure(s), outcome(s) and main findings, with an eye on social inequalities in health. Out of the 69 articles reviewed, most were quantitative, cross-sectional, conducted among 18-year-olds and younger, and focused on the residential neighborhood. Neighborhood social capital and mental health were the most common exposure and outcome studied, respectively. Almost half of the studies examined social inequalities in health, mostly across sex/gender, socioeconomic status, and ethnicity. Evidence gaps remain, which include exploring settings other than residential neighborhoods, studying the older age stratum of young adulthood, and assessing a broader range of social inequalities. Addressing these gaps can support research and action on designing healthy and equitable neighborhoods for young people.

Role of the neighborhood environment in psychological resilience

Psychological resilience of residents is an important but often neglected component of community and urban resilience. This study explores what neighborhood environment features contribute to better psychological resilience. Using a survey conducted in Greater Melbourne during a COVID-19 pandemic lockdown, we examined the role of the neighborhood physical and social environments in mitigating the psychological shock of the pandemic. Overall, we found that suburban residents are more resilient in mental health than those in the inner city. In particular, the mental health of residents living in middle-density suburbs is least likely to be severely impacted. We further found that neighborhood walkability, vegetation cover, and social cohesion all contribute to better psychological resilience. Walkability and social cohesion influence psychological resilience indirectly through affecting the perceived risks of COVID-19 infection and satisfaction with neighborhood during the lockdown, whereas neighborhood greenery has a direct and beneficial effect on psychological resilience. These findings imply that planning interventions to improve neighborhood walkability and greenness, and foster social cohesion may help improve the psychological resilience of local residents, and hence promote urban resilience. These findings also support middle-density development, which promotes walkability and proximity to nature, as well as a close-knit community.

Age as effect modifier of the associations between the physical environment and adults' neighborhood walking in the Netherlands

Walking contributes to people's physical activity. While the physical environment (i.e., built and natural environmental characteristics) seems to be associated with people's neighborhood walking behavior, there is little evidence how these associations are moderated by age and vary across levels of urbanicity. This study examined the moderating effects of age and urbanicity on the associations between the neighborhood physical environment and the recreational and transportation walking of adults in the Netherlands. We used data on adults aged ≥ 18 years (N=65,785) taken from the Dutch National Travel Survey for 2015–2017. The outcome variable was the total duration of daily walking separately for recreation and transportation. We assessed the characteristics of the natural and built environments objectively based on respondents' home addresses within 300 m, 600 m, and 1000 m buffers. Tobit regression models with interaction terms between age and the physical environment were fitted. The results showed that age significantly modified the walking-environment associations and the moderating effects differed between weekdays and weekends. We also found that environmental characteristics (like residential density) correlated with walking differently among different age groups across urban and rural areas. Interventions intended to stimulate walking should be tailored to specific places and age groups.

Food Intake and Food Selection Following Physical Relocation: A Scoping Review.

Objectives: To synthesize the current available evidence on the changes in food intake and food selection after physical relocation in non-refugee populations. Methods: The inclusion criteria were studies with a measurement of food selection and/or food intake in non-refugee populations where physical relocation had occurred with self-reported or objective assessment of the neighbourhood physical environment before and after relocation. Databases searched included MEDLINE, EMBASE, CINAHL and SCOPUS from 1946 to August 2022. Results: A total of four articles met the inclusion criteria. Overall, these studies gave longitudinal (n = 2) and cross-sectional (n = 2) evidence to suggest that moving to an urban neighbourhood with more convenience stores, cafés and restaurants around the home was associated with an increase in unhealthy food intake in adult populations. Additional factors such as income, vehicle access, cost, availability and perceptions of the local food environment played a role in shaping food selection and food intake. Conclusion: Four internal migration studies were found. The limited evidence base calls for more research. Future studies should include children and apply appropriate research designs to account for neighbourhood self-selection and concurrent life events. International migration studies should include assessment of neighbourhood physical environments pre- and post-relocation.

The influence of neighborhood safety and built environment on childhood obesity: isolated and combined effect of contextual factors.

This study aims to analyze the isolated and combined effect of objective measures concerning neighborhood safety, food, and physical activity environments on students' obesity. This is a cross-sectional study conducted with 9- and 10-year-old children enrolled in the municipal education network of a Brazilian metropolis. Environment objective measures comprised neighborhood unsafety (annual criminality and road traffic accident rates), availability of public parks and spaces for physical activity practicing, and index of establishments that predominantly sell ultra-processed food. Euclidean buffers of 1,000m around the children's house were used as eligible geographic units. This study adopted the Principal Component Analysis and Generalized Estimation Equation models. Stratified analyses were conducted based on neighborhood unsafety and on child's family income. In total, 717 students were assessed, 12.2% of them were children with obesity. The latent variable of the obesogenic environment (deduced by environment unsafety rates and the index of establishments that predominantly sell ultra-processed food) was a risk factor for obesity in children with lower socioeconomic levels (OR = 2.37; 95%CI: 1.06-5.19). Public parks and spaces for physical activity practicing were protective factors against childhood obesity only in locations recording the lowest environment unsafety rates (OR = 0.30; 95%CI: 0.09-0.94). Based on our findings, social conditions change the effect of the environment on childhood obesity, reinforcing the relevance of inter-sectoral policies and strategies against this condition.

Association between neighborhood physical characteristics and mental health among older adults in Spain

The aim was to assess the impact of neighborhood physical environment on mental health among non-institutionalized older adults. A cross-sectional analysis was conducted over a representative sample of 5,071 people ≥65 years from the Spanish National Health Survey. The survey included nine items addressing the self-perceived degree of discomfort due to neighborhood physical problems. Participants were categorized into groups with “no problems”, “some problems” (somewhat discomfort on 1–4 items) and “many problems” (somewhat discomfort on ≥5 items or very much discomfort on ≥1 item). Mental health status was assessed using the General Health Questionnaire, consisting of 12 items assessing the severity of a psychological distress over the past few weeks. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regressions. A dose-response association (p-trend<0.001) was found between living in neighborhoods with some (OR: 1.41; 95% CI: 1.14–1.75) or many problems (OR: 1.93; 95% CI: 1.55–2.42) affecting the physical environment with poor mental health of community dwelling older adults. Integrating and articulating health considerations into public policymaking regarding housing and the residential environment can have broad implications for healthy aging.

Obstacles to emancipation in neighborhood regeneration: The case study of Dong Gang New Town, Suzhou

In recent years a neighborhood regeneration policy has been implemented at the Chinese national level to tackle deprivation in old neighborhoods. This article elucidates neighborhood regeneration based on concepts of neighborhood, social innovative urban governance, and social capital using the case study of Dong Gang New Town in Suzhou Industrial Park. The findings show that the implementation of the neighborhood regeneration policy has no significant impact on the neighborhood governance. In addition, findings indicate that the regeneration process was not emancipated, although some of residents’ needs were met by the regeneration. The results also show that this is due to weak linking social capital among resident, non-government organizations and the local government. This article concludes with policy suggestions on local organizations’ role to improve neighborhood governance for better neighborhood physical environments in Dong Gang New Town

Allostatic load and the influence of economic adversity and neighborhood disadvantage on cognitive function in a multiethnic cohort

AbstractBackgroundPrevious research has demonstrated a link between objective socio‐economic indicators and cognitive test performance. Although some studies include subjective indicators, such as perceived neighborhood environment, little is known about which specific factors are most strongly associated with cognitive performance and whether these measures are useful beyond traditional SES proxies. Further, in addition to being disproportionately at risk of experiencing neighborhood disadvantage and lower SES, racial/ethnic minorities are more likely to be diagnosed with dementia and receive less timely care compared with White individuals. This study aims to investigate how perceived neighborhood environment and neighborhood disadvantage are related to cognitive performance within a large diverse sample.MethodA probability‐based sample of participants (N = 3858; Female = 59%; Black = 51%; Hispanic = 14%) from the Dallas Heart Study Phase 2 (DHS‐2; Mean: Age = 50, Education = 13) were administered the Montreal Cognitive Assessment (MoCA), in addition to measures of perceptions of neighborhood physical environment and violence, and perceived SES. Multiple regression was used to determine associations of these variables with MoCA scores relative to traditional SES measures (i.e., income, education), controlling for demographic and relevant health factors. Post‐hoc analyses stratified by racial/ethnic group were conducted to determine whether indicators differentially influenced test scores.ResultAfter controlling for socio‐demographic and health factors, reporting lower quality neighborhood resources and difficulty paying for “very basics like food and heating” and “medical care” were associated with lower MoCA scores in the overall sample. Post‐hoc analyses revealed significant relationships between MoCA scores and quality of neighborhood resources, “food and heating,” and “medical care” only in Black participants, while “violence” was significantly associated with lower MoCA scores in Hispanics. There were no significant relationships found in Whites. Overall, subjective measures of SES and neighborhood environment contributed modest variance in the overall model, specifically for Black and Hispanic participants (R 2 = 3% to 5%).ConclusionExperiencing neighborhood and economic adversity was associated with lower scores on a cognitive screening measure and accounted for more variance than income or education in Black individuals and income in Hispanic individuals, while no relationship was seen in White participants. Future research is needed to determine whether these allostatic stressors influence cognitive impairment or dementia later in life.