Objective Neighborhood Characteristics Research Articles

Psychosocial Risks and Adolescent Mental Health: The Moderating Role of Objective Neighborhood Characteristics

PurposeAlthough previous studies have examined the association between youth psychosocial risks and their perceptions of their neighborhood, it is unclear how objective neighborhood characteristics are associated with psychosocial risks and mental health symptoms among adolescents. We investigated how neighborhood characteristics moderate the relationship between youth psychosocial characteristics and mental health symptoms. MethodsThis cross-sectional study examined 13,837 emergency department visits by 14–18-year-olds who completed a standardized Behavioral Health Screening in a tertiary pediatric hospital in Philadelphia from 2013 to 2020. Psychosocial risk factors and mental health symptoms were assessed based on self-reported survey responses. We characterized neighborhoods as low-, moderate-, and high-stress based on gun violence incidence from 2013 to 2020 and the census tract–level Child Opportunity Index. Mixed effects logistic regression and Poisson models were used to examine moderation effects. ResultsThe 9,814 included patients were 64% female and 64% non-Hispanic Black. The following psychosocial risk factors were associated with two to eight times higher odds of depressive symptoms and suicide risk: exposure to trauma, bullying at school, at-risk substance use, fighting, and retaliation. Adolescents living in high-stress neighborhoods were twice as likely to report fighting and retaliation and reported more psychosocial risk factors than those in low-stress neighborhoods. Odds of mental health symptoms increased with the number of psychosocial risk factors, particularly in youth from low-stress neighborhoods. DiscussionObjective neighborhood characteristics had a significant interaction effect on the relationship between psychosocial risks and depression and suicide risk among adolescents seeking care in a pediatric emergency department.

Associations of objective and subjective neighborhood measures with cognitive change in a repeated measurement burst design

AbstractBackgroundPrior studies have reported associations between neighborhood characteristics and late‐life cognition. These studies assessed neighborhood using either objective (e.g., area‐level data from public database) or subjective (individual‐level perception) measures. However, little research has been done to examine effects of objective and subjective measures simultaneously. The present study aims to investigate the independent associations of objective and subjective neighborhood characteristics with cognitive change in older adults.MethodParticipants include 316 individuals in the Einstein Aging Study (mean age = 77; 67% females; 45% non‐Hispanic Whites, 40% non‐Hispanic Blacks). Subjective neighborhood measures included perceived neighborhood safety, aesthetic quality, social cohesion, and availability of healthy foods (range = 1 poor to 5 excellent). Objective neighborhood measures included violent crime, neighborhood deprivation, volunteering rates, percentage of healthy food retailers, and low access to healthy food. Processing speed was assessed using the brief, smartphone‐administered Symbol Search Test, and was completed 6x/day over two weeks; this was repeated annually from 2017 to 2022. To account for non‐linear retest/practice effects, double negative exponential models were used to estimate the relation of neighborhood measures to asymptotic performance (i.e., fastest response time) at baseline and to change in asymptotic performance over time.ResultMost subjective and objective neighborhood measures were significantly correlated with each other (Table 1). In models containing both objective and subjective neighborhood measures, better perceived safety was associated with greater annual improvement in asymptotic performance (40 milliseconds/year for one point increase in safety) while the objective measure of violent crime was not. Perceived availability of healthy foods was independently associated with a faster baseline asymptotic processing speed (estimate = 160 milliseconds) and with greater annual improvement rate (estimate = 54 milliseconds/year) while the objective measures of food environment were not (Table 2).ConclusionSubjective rather than objective neighborhood characteristics were strongly associated with annual rates of change in processing speed over five years in community‐dwelling older adults. Perception of one’s neighborhood may be a more proximal predictor of cognitive health as it may reflect an individual’s lived experiences and determine one’s psychological states and health‐related behaviors. Alternatively, more fine‐grained objective neighborhood measures (e.g., individual‐level) would be necessary to better characterize objective neighborhood environments.

Neighborhood Social Cohesion and Loneliness in Mid- and Later Life: Are Benefits Contingent on Race/Ethnicity or Neighborhood Disorder?

Connections between social integration and health throughout the life span are well established, including at the neighborhood level and among older adults. Less explored is how pathways between neighborhood social cohesion and well-being may differ by race/ethnicity or by neighborhood disorder. This study investigates whether perceived neighborhood social cohesion is associated with loneliness in adults aged 50 and older, and whether this association is moderated by race/ethnicity or perceived neighborhood disorder. We used pooled cross-sectional data from the 2016 and 2018 waves of the Health and Retirement Study and respondents to the Leave-behind Questionnaire age 50 and older, living in the community (N = 10,713). Data were analyzed using multivariate ordinary least squares regression. Perceived social cohesion was negatively associated with loneliness (B = -0.13, p < .001); however, this effect was strongest among White respondents, and significantly weaker for respondents who were Black (B = 0.02, p < .05), Hispanic (B = 0.03, p < .05), or of another race/ethnicity (B = 0.03, p < .05). Further, neighborhood disorder moderated the association between social cohesion and loneliness (B = 0.02, p < .001), reducing the strength of relationship for those in areas of high disorder. Inclusion of this interaction also attenuated the interaction between neighborhood cohesion and race for Black older adults. Findings show that neighborhood social cohesion matters for midlife and older adults' loneliness, but that this relationship varies by race/ethnicity and neighborhood disorder. As such, neighborhood racial/ethnic makeup and both social and objective neighborhood characteristics should be considered when designing interventions to reduce loneliness.

Neighborhood and Depressive Symptoms in Older Adults Living in Rural and Urban Regions in South Korea

Neighborhoods have a significant impact on depressive symptoms in older adults. In response to the increasing depression of older adults in Korea, this study aims to identify the relationship between perceived and objective neighborhood characteristics in depressive symptoms and find differences between rural and urban areas. We used a National survey collected in 2020 of 10,097 Korean older adults aged 65 and older. We also utilized Korean administration data for identifying the objective neighborhood characteristics. Multilevel modeling results indicated that depressive symptoms decreased when older adults perceived their housing condition (b = -0.04, p < 0.001), their interaction with neighbors (b = -0.02, p < 0.001), and overall neighborhood environment (b = -0.02, p < 0.001) positively. Among the objective neighborhood characteristics, only nursing homes (b = 0.09, p < 0.05) were related to depressive symptoms of older adults living in urban areas. For older adults living in rural areas, the number of social workers (b = -0.03, p < 0.001), the number of senior centers (b = -0.45, p < 0.001), and nursing home (b = -3.30, p < 0.001) in the neighborhood were negatively associated with depressive symptoms. This study found that rural and urban areas have different neighborhood characteristics related to older adults' depressive symptoms in South Korea. This study encourages policymakers to consider neighborhood characteristics to improve the mental health of older adults.

NEIGHBORHOOD IMPACTS ON KOREAN OLDER ADULTS’ DEPRESSION

Abstract Older adults are more influenced by their neighborhood than young adults, however neighborhood impacts on older adults are little known. In response to the increasing depression of older adults in Korea, this study aims to identify the effect of perceived and objective neighborhood characteristics in depression and find differences between rural and urban areas. This study uses the Korean Elderly Survey conducted in 2020 on 10,097 older adults aged 65 and over residing in 17 states, and Korean administration data by connecting them. Multilevel modeling results show that after controlling individual characteristics, depression decreases when older adults perceive their housing condition (b=-.64, p&amp;lt;.001), interaction with neighbors (b=-.29, p&amp;lt;.001), overall neighborhood environment (b=-.26, p&amp;lt;.001) positively. Although objective neighborhood characteristics do not significantly reduce depression in older adults living in urban area, for older adults living in rural areas, the number of social worker (b=- .42, p &amp;lt;.001), the number of senior center (b=-6.70, p&amp;lt;.001), and home care services (b=-49.5, p &amp;lt;.001) are negatively associated with depression in older adults. This study discusses that neighborhood characteristics may play an important role in older adults’ depression, and that their effects may differ between rural and urban areas. This study encourages policy makers to consider neighborhood characteristics to improve the mental health of Korean older adults.

Impact of subjective and objective neighbourhood characteristics and individual socioeconomic position on allostatic load: A cross-sectional analysis of an all-age UK household panel study.

Research suggests that individuals living in more disadvantaged neighbourhoods experience higher levels of stress but this has generally been based on self-reported stress. We used survey-based neighbourhood quality indicators and biomarker data from Understanding Society, linked to census and crime statistics to explore associations of allostatic load (AL), an objective biomarker-based measure of cumulative stress, with subjective and objective neighbourhood characteristics. Analyses of 6887 respondents living in England show greater AL among those living in more disadvantaged areas, with objective measure associations stronger than subjective. Neighbourhood inequalities in AL were lower among respondents with higher individual SEP. These results suggest that individual-level SEP mitigates against the impact of negative, particularly objective, neighbourhood characteristics. Policies to reduce health inequalities should consider both individual and neighbourhood circumstances.

Objective and subjective neighbourhood characteristics and suicidality: a multilevel analysis.

Characteristics of the neighbourhood environment, including population density, social fragmentation, and trust, have been linked to mental health outcomes. Using a longitudinal population-based cohort, we explored the relationship between objective and subjective neighbourhood characteristics and the odds of suicidal thoughts and attempts. We conducted a longitudinal study of 20764 participants living in Stockholm County who participated in the Stockholm Public Health Survey. We used multilevel modelling to examine if suicidal thoughts and attempts were associated with neighbourhood characteristics, independent of individual associations. We included objective and subjective measures to explore if there was a different relationship between these measures of the neighbourhood environment and suicidality. Associations between neighbourhood factors and suicidality were predominantly explained by individual characteristics, with the exception of neighbourhood-level deprivation and average residential trust. Each unit increase of deprivation was linked to increased odds of suicidal thoughts [Odds ratio (OR) 1.04, 95% confidence interval (CI) 1.00-1.07] and attempts (OR 1.11, 95% CI 1.06-1.17). Decreasing residential trust was associated with increased odds of suicide attempts (OR 1.09, 95% CI 1.02-1.17). There was no evidence that neighbourhood-level fragmentation or average trust in public and political institutions had an independent effect on suicidality once individual and sociodemographic factors were accounted for. This study showed that much of the neighbourhood-level variation in suicidal thoughts and attempts could be explained by compositional factors, including sociodemographic clustering within neighbourhoods. The independent effect of neighbourhood-level deprivation and average residential trust provide evidence that the neighbourhood context may exert an independent effect on suicidality beyond the impact of individual characteristics.

Location, Location, Location: The Role of Objective Neighborhood Characteristics for Perceptions of Control

Introduction: Control beliefs can protect against age-related declines in functioning. It is unclear whether neighborhood characteristics shape how much control people perceive over their life. This article studies associations of neighborhood characteristics with control beliefs of residents of a diverse metropolitan area (Berlin, Germany). Methods: We combine self-report data about perceptions of control obtained from participants in the Berlin Aging Study II (N = 507, 60–87 years, 51% women) with multisource geo-referenced indicators of neighborhood characteristics using linear regression models. Results: Findings indicate that objective neighborhood characteristics (i.e., unemployment rate) are indeed tied to perceptions of control, in particular, how much control participants feel others have over their lives. Including neighborhood characteristics in part doubled the amount of explained variance compared with a reference model covarying for demographic characteristics only (from R2 = 0.017 to R2 = 0.030 for internal control beliefs; R2 = 0.056 to R2 = 0.102 for external control beliefs in chance; R2 = 0.006 to R2 = 0.030 for external control beliefs in powerful others). Discussion/Conclusion: Findings highlight the importance of access to neighborhood resources for control beliefs across old age and can inform interventions to build up neighborhood characteristics which might be especially helpful in residential areas with high unemployment.

Perception Versus Reality: Subjective and Objective Neighborhood Characteristics and Cognitive Function in REGARDS

Does the world shrink as we age? The neighborhood captures a spatial area someone inhabits and moves through on a daily basis. It reflects a balance between internal perceptions and abilities, and the external environment which may enable or restrict participation in everyday life. We frequently hear that older adults have shrinking neighborhoods given declining functional mobility. This is associated with declines in physical and cognitive functioning, depression, poorer quality of life, and mortality. Knowledge of the interplay between objective and subjective neighborhood measurement remains limited. This symposium will explore these linked yet distinct constructs based on secondary data analyses of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a racially diverse sample of 30,000+ aging Americans. Finlay investigates how someone’s perceived neighborhood size (in number of blocks) varies by individual and geographic characteristics including age, cognitive function, self-rated health, and urban/rural context. Esposito’s analyses focus on neighborhood size in relation to race and residential segregation. Clarke compares subjective perceptions of neighborhood parks and safety from crime to objective indicators, and examines variations by health and cognitive status. Barnes will critically consider implications for how older adults interpret and engage with their surrounding environments. The symposium questions the validity of neighborhood-based metrics to reflect the perspectives and experiences of older residents, particularly those navigating cognitive decline. It informs policy-making efforts to improve physical neighborhood environments and social community contexts, which are critical to the health and well-being of older adults aging in place.

Childhood maltreatment and lead levels in middle adulthood: A prospective examination of the roles of individual socio-economic and neighborhood characteristics.

BackgroundLead is a common environmental hazard because of its past use as an additive to gasoline and household paint. Some evidence suggests that children with histories of child abuse and neglect are at elevated risk for residence in communities and households with less desirable characteristics and high levels of exposure to environmental hazards and toxins.ObjectivesTo understand whether childhood maltreatment leads to higher levels of household dust lead and blood lead in adulthood and the extent to which characteristics of a person’s physical environment or individual level socio-economic status (SES) (based on unemployment, poverty, and receipt of public assistance) contribute to understanding the relationship.MethodsA large prospective cohort design study in which abused and neglected children (ages 0–11) were matched with non-maltreated children and assessed in adulthood. Objective and subjective neighborhood characteristics were assessed at approximate age 40 and household dust lead (cleaned and less often cleaned) and blood lead levels were measured at age 41. Blood was collected through venipuncture by a registered nurse as part of a medical status exam.ResultsChildhood maltreatment predicted higher levels of dust lead in less often cleaned household places, residence in worse neighborhoods defined by objective (census tract data) and subjective (reports of physical disorder and lack of social cohesion and control), and higher levels of poverty, receiving public assistance, and unemployment. Only objective neighborhood characteristics mediated the relationship between childhood maltreatment and dust lead level in adulthood. There were also significant paths from objective neighborhood disadvantage and individual level SES to higher levels of blood lead.DiscussionThirty years after their childhood experiences, individuals with documented histories of childhood maltreatment are at higher risk for living in environments as adults with elevated lead levels that may impact other aspects of their lives and compromise their health.

Individual-level intervention: How perceptions of neighborhood matter for social organization

ABSTRACT One of the most robust areas of research in the communities and crime literature investigates the relationship between neighborhood social control and levels of neighborhood crime. While macro-level research provides much insight into the necessary conditions for neighborhoods to exert social control, and as a result experience less crime, far less attention is paid to the determinants of individual-level decisions to intervene in neighborhoods. This study takes a micro-level approach to studying neighborhood social organization by investigating how individual-level perceptions shape resident behaviors within neighborhoods. This paper argues that more attention should be placed on what motivates people to intervene in their neighborhoods, thus contributing to collective efficacy through individual actions. Using survey data from the Study of Race, Crime, and Social Policy in Oakland, California (Street, 2000), analyses show that residents within the same neighborhoods vary in how they perceive objective neighborhood characteristics, and that this variation partly accounts for the likelihood of intervention. Specifically, results from a series of logistic regressions show that perceptions of neighborhood disorder and perceptions of the legal system influenced whether neighborhood residents intervened when presented with problems in their communities.

Cross-sectional associations of neighbourhood socioeconomic disadvantage and greenness with accelerometer-measured leisure-time physical activity in a cohort of ageing workers

ObjectiveNeighbourhood characteristics may affect the level of physical activity (PA) of the residents. Few studies have examined the combined effects of distinctive neighbourhood characteristics on PA using objective data or...

Neighborhood environment perceptions associate with depression levels and cardiovascular risk among middle-aged and older adults: Data from the Washington, DC cardiovascular health and needs assessment

Objectives Little is understood about associations between neighborhood characteristics and depression, a cardiovascular disease (CVD) risk factor, in diverse populations. We examined relationships between perceived/objective neighborhood characteristics, depression, and CVD markers within the Washington, DC CV Health/Needs Assessment, an evaluation among predominantly African-American (AA) adults in resource-limited DC communities. Method Factor analysis of overall neighborhood environment perception (NEP) identified three NEP sub-scores:1) violence; 2) physical/social environment; 3) social cohesion (higher score = more favorable perception). Objective neighborhood characteristics were measured by geospatially-derived scores of walkability, transportation, and crime. Depression was defined by the revised Center for Epidemiologic Studies Depression Scale (CESD-R). We used linear-regression modeling to examine neighborhood measures and CESD-R associations. To investigate a subsequent connection with CVD risk, we examined relationships between CESD-R and CVD-associated cytokines in a population subset. Results Participants (N = 99; mean age = 59.06; 99% AA) had a mean CESD-R score = 5.8(SD = 8.88). In adjusted models, CESD-R scores decreased by 0.20 units (p = 0.01) for every overall NEP unit-increase. Perceived physical/social environment (β = −0.34, p = 0.04) and social cohesion (β = −0.82, p = 0.01) were related to CESD-R while perceived violence was not (β = −0.28, p = 0.1). Of objective neighborhood environment measures (i.e. walk, transit, bike, personal crime, and property crime scores), only property crime score was associated with depression (β = 4.99, p < 0.03). In population subset (n = 42), higher CESD-R associated with higher IL-1β (β = 21.25, p < 0.01) and IL-18 (β = 0.006, p = 0.01). Conclusion Favorable neighborhood perceptions are related to lower depressive symptoms in a predominantly AA cohort from Washington, DC resource-limited communities. Neighborhood perceptions appear to be strongly associated with depressive symptoms compared to objective characteristics. Increasing CESD-R scores were related to higher pro-inflammatory markers. Improving neighborhood perceptions may be beneficial to psychological well-being and CV health for urban minority residents.

Epigenetic predictors of all-cause mortality are associated with objective measures of neighborhood disadvantage in an urban population

BackgroundNeighborhood characteristics are robust predictors of overall health and mortality risk for residents. Though there has been some investigation of the role that molecular indicators may play in mediating neighborhood exposures, there has been little effort to incorporate newly developed epigenetic biomarkers into our understanding of neighborhood characteristics and health outcomes.MethodsUsing 157 participants of the Detroit Neighborhood Health Study with detailed assessments of neighborhood characteristics and genome-wide DNA methylation profiling via the Illumina 450K methylation array, we assessed the relationship between objective neighborhood characteristics and a validated DNA methylation-based epigenetic mortality risk score (eMRS). Associations were adjusted for age, race, sex, ever smoking, ever alcohol usage, education, years spent in neighborhood, and employment. A secondary model additionally adjusted for personal neighborhood perception. We summarized 19 neighborhood quality indicators assessed for participants into 9 principal components which explained over 90% of the variance in the data and served as metrics of objective neighborhood quality exposures.ResultsOf the nine principal components utilized for this study, one was strongly associated with the eMRS (β = 0.15; 95% confidence interval = 0.06–0.24; P = 0.002). This principal component (PC7) was most strongly driven by the presence of abandoned cars, poor streets, and non-art graffiti. Models including both PC7 and individual indicators of neighborhood perception indicated that only PC7 and not neighborhood perception impacted the eMRS. When stratified on neighborhood indicators of greenspace, we observed a potentially protective effect of large mature trees as this feature substantially attenuated the observed association.ConclusionObjective measures of neighborhood disadvantage are significantly associated with an epigenetic predictor of mortality risk, presenting a potential novel avenue by which neighborhood-level exposures may impact health. Associations were independent of an individual’s perception of their neighborhood and attenuated by neighborhood greenspace features. More work should be done to determine molecular risk factors associated with neighborhoods, and potentially protective neighborhood features against adverse molecular effects.

The Role of Neighborhood Experiences in Psychological Distress among African American and White Smokers.

Residential area characteristics and discrimination have been associated with psychological distress. Differences in these relationships across racial groups are not well understood. We examined the relative role of perceived discrimination, neighborhood problems and neighborhood cohesion/trust in explaining differences in psychological distress (indicated by anxiety and depressive symptoms) between 224 African American and 225 White smokers (income ≤ 400% federal poverty level) in a smoking cessation intervention study. Surveys were linked to US census-tract data. We conducted random intercept Poisson multi-level regression models and examined interactions between race and neighborhood experiences. African Americans had greater risk of anxiety and depressive symptoms and greater individual and neighborhood disadvantage than Whites. Controlling for objective neighborhood characteristics, when perceived discrimination and perceived neighborhood characteristics were added to the regression models the association between anxiety symptoms and race were no longer statistically significant; the association between depressive symptoms and race decreased but remained statistically significant. Lower neighborhood social cohesion/trust and greater neighborhood problems increased depressive symptoms for African Americans, but not for Whites. Perceived discrimination and neighborhood social cohesion/trust outweighed the importance of race in explaining anxiety symptoms. These findings underscore the need for multi-level interventions addressing social and environmental contexts.

Neighborhood Profiles and Associations with Coping Behaviors among Low-Income Youth.

Extant research has typically examined neighborhood characteristics in isolation using variable-centered approaches; however, there is reason to believe that perceptions of the neighborhood environment influence each other, requiring the use of person-centered approaches to study these relationships. The present study sought to determine profiles of youth that differ in their perceptions of their neighborhoods and objective neighborhood characteristics, and whether these profiles are associated with youth coping. Participants were low-income, African American youth (N= 733; 51.0% female, M age = 18.76 years, SD = 1.71) from a metropolitan city who were originally recruited for the Youth Opportunity program in Baltimore, Maryland. A latent profile analysis was conducted which included self-reported neighborhood social cohesion, collective efficacy, disorder, violence, and disadvantage derived from census data. Coping behaviors, specifically positive cognitive restructuring, problem-focused coping, distraction strategies, and avoidant behaviors were assessed via self-reported questionnaires. Four neighborhood profiles were identified: highest disorder (20.0%); highest violence/highest disadvantage (5.2%); high violence (26.6%); and highest cohesion/lowest disorder (48.2%). Individuals in the highest violence/highest disadvantage profile reported higher positive cognitive restructuring and problem-focused coping than the other profiles. These findings warrant an investigation into the individual assets and contextual resources that may contribute to more positive coping behaviors among youth in more violent and disadvantaged neighborhoods, which has the potential to improve resilient outcomes among youth in similar at-risk settings.

The role of perceived environment, neighbourhood characteristics, and attitudes in walking behaviour: evidence from a rapidly developing city in China

The associations between objective and subjective dimensions of the built environment and walking behaviour have been examined extensively in existing studies. However, the interaction effects of those dimensions of the built environment on walking behaviour are understudied and may be more complex than hitherto suggested. Apart from the subjective dimensions of the built environment, walking attitudes also play a role in moderating these relationships. This paper investigates the independent and joint effects of objective neighbourhood characteristics, people’s perceptions of the neighbourhood environment, and walking attitudes on the frequency of walking by using Shenzhen as a case study. Since those effects may vary across different kinds of walking trips, the analysis looks separately at three major types of walking at the neighbourhood level—walking for work/school, walking for leisure/recreation, and walking for household responsibilities. Logistic regression analyses confirm that the correlates of people’s walking frequency vary considerably among different types of walking. Statistically significant interaction effects of objective neighbourhood characteristics and perceived environment are found. The results suggest that positive perceptions of the environment can compensate for the effect that low objective walkability of neighbourhoods has on people’s walking frequency. When seeking to encouraging walking at the neighbourhood level, policymakers should not only concentrate on improving objective neighbourhood characteristics but also consider people’s perception of the neighbourhood environment and their attitudes towards walking.

Eclipsing Community? Neighborhood Disadvantage, Social Mechanisms, and Neighborly Attitudes and Behaviors

This study investigates how objective neighborhood characteristics influence attitudinal and behavioral dimensions of community social organization. Grounded in ecological and neighborhood effects traditions, I extend prior inquiries by adjudicating the social mechanisms that link neighborhood disadvantage with residents’ satisfaction and neighboring. Results from longitudinal data from the Los Angeles Family and Neighborhood Survey indicate that the neighborhood disadvantage perspective garners support when considering neighborhood satisfaction, while the systemic model marshals support for informal neighboring. Consistent with the local danger model, experiencing fearful feelings toward the neighborhood is detrimental to both satisfaction and neighboring. In addition, a cumulative disadvantage effect exists whereby individuals who live in highly disadvantaged areas and perceive the neighborhood as dangerous exhibit the highest levels of dissatisfaction. Having friendship ties living nearby buffers the impact of fear on neighborhood satisfaction, while being socially isolated exacerbates feelings of local danger. These findings suggest that community investment initiatives could mitigate the factors contributing to disadvantaged neighborhoods and foster local satisfaction and engagement as a result.

Neighborhood disadvantage is associated with actigraphy-assessed sleep continuity and short sleep duration.

Neighborhood disadvantage has been linked to poor sleep. However, the extant research has primarily focused on self-reported assessments of sleep and neighborhood characteristics. The current study examines the association between objective and perceived neighborhood characteristics and actigraphy-assessed sleep duration, efficiency, and wakefulness after sleep onset (WASO) in an urban sample of African American adults. We examined data from predominantly African American adults (n = 788, mean age 55 years; 77% female) living in two low-income neighborhoods. Perceived neighborhood characteristics included safety, social cohesion, and satisfaction with one's neighborhood as a place to live. Objective neighborhood conditions included walkability, disorder, street lighting, and crime levels. Sleep duration, efficiency, and WASO were measured via 7 days of wrist-worn actigraphy. Analyses estimated each of the sleep outcomes as a function of perceived and objective neighborhood characteristics. Individual-level sociodemographics, body mass index, and psychological distress were included as covariates. Greater perceived safety was associated with higher sleep efficiency and shorter WASO. Greater neighborhood disorder and street lighting were associated with poorer sleep efficiency and longer WASO and greater likelihood of short sleep duration (<7 versus 7-9 hr as referent). Higher levels of crime were associated with poorer sleep efficiency and longer WASO, but these associations were only evident in one of the neighborhoods. Both how residents perceive their neighborhood and their exposure to objectively measured neighborhood disorder, lighting, and crime have implications for sleep continuity. These findings suggest that neighborhood conditions may contribute to disparities in sleep health.

Do Sleep and Psychological Distress Mediate the Association Between Neighborhood Factors and Pain?

Pain affects millions of American adults. However, individuals from socioeconomically disadvantaged groups experience higher rates of pain, and individuals from racial/ethnic minorities report greater pain severity and pain-related disability. Some studies find an association between neighborhood socioeconomic status and pain. The present study aimed to further understand the association between neighborhood disadvantage and pain, including the role of objective (e.g., crime rates) and subjective neighborhood characteristics (e.g., perceived safety, neighborhood satisfaction), and to examine sleep and psychological distress as potential mediators of these associations. The sample included 820 participants from two predominantly African American socioeconomically disadvantaged neighborhoods. Trained data collectors interviewed participants on a number of self-report measures, and objective neighborhood characteristics were obtained from city crime data and street segment audits. Subjective characteristics, specifically perceived infrastructure and perceived safety, were associated with pain. Based on bootstrapped regression models, sleep efficiency and psychological distress were tested as mediators of the association between these neighborhood factors and pain. Results of mediation testing indicated that psychological distress served as a significant mediator. Though sleep efficiency was not a mediator, it had a significant independent association with pain. Understanding the contribution of sleep problems and psychological distress to pain among at-risk individuals living in disadvantaged neighborhoods is important to identifying ways that individual- and neighborhood-level interventions may be leveraged to reduce pain-related disparities.