Neighborhood Outcomes Research Articles

Migration and neighbourhood trust: Evidence from urban China

Neighbourhood outcomes of migration have drawn considerable scholarly attention. Previous studies consider neighbourhood trust an indicator of social integration or social resources, revealing inconclusive findings regarding the effects of migration. Unlike previous studies, we view neighbourhood trust as a lifestyle feature. Combining urbanism theory and a typology of trust, we argue that migration causes a reduction in migrants’ neighbourhood trust through the assimilation of the urbanism lifestyle. We provide nationwide empirical evidence of the causal relationship between migration and neighbourhood trust and reveal the underlying mechanism. Our study identifies this relationship in urban China by applying a difference-in-differences empirical strategy and using the China Family Panel Survey. The results show that migration lowers neighbourhood trust levels by 0.473 from a sample mean of 6.692. We find that the declining effect is greater for rural–urban migrants than for within-urban migrants, and it is greater for rural–urban migrants who acquire urban hukou than for those who do not. We also show that rural–urban migration leads to an increase in trust in strangers. Together, these results support our hypothesis that the assimilation of the urbanism lifestyle is a critical mechanism through which migration undermines neighbourhood trust.

White privilege, ethnic disadvantage, and stigmatized linguistic capital: COVID-19 infection rates and lockdown law enforcement in Hong Kong

The COVID-19 pandemic has exposed and exacerbated existing disparities in various societies. This study investigates disparities among racial, ethnic, and linguistic groups in Hong Kong's society in COVID-19 infection rates and lockdown enforcement practices that was imposed 545 times from January 2021 to September 2022 and affected 9% of the population. It is found that neighborhoods with more white individuals had lower infection rates than the overall population, while those with more ethnically minoritized groups had higher infection rates. Furthermore, hit rate tests reveal that the government targeted more neighborhoods with a higher share of individuals from linguistically minoritized groups. This novel finding suggests that not only race, but linguistic difference of the same ethnicity can cause bias. The study highlights the positive impact of providing ethnic support services on health outcomes in neighborhoods with a higher share of individuals from ethnically minoritized groups.

Exploring the impact of health education on medication adherence and health outcomes in low-income neighborhoods: An observational study

Background: Medication adherence and health outcomes are influenced by multiple factors, including patient education. Aims and Objectives: The aims and objectives of the study are to explore the impact of health education on medication adherence and various health outcomes in low-income neighborhoods. Materials and Methods: An observational study was conducted involving 100 participants from low-income neighborhoods, aged 18–65, who were prescribed at least one chronic medication. Participants underwent a comprehensive health education program focusing on medication adherence, potential side effects, dietary habits, and physical activity. Outcomes were measured using the Morisky Medication Adherence Scale (MMAS-8), biometric values (e.g., blood pressure, blood sugar levels, cholesterol, and body mass index [BMI]), self-reported health status, hospitalization records, medication side-effects awareness, and dietary habits. Results: Post-education, there was a significant improvement in MMAS-8 scores (5.3 pre to 6.8 post, P<0.001). Biometric outcomes revealed a decrease in average blood pressure (from 145/90 mmHg to 130/85 mmHg), fasting blood sugar (from 150 mg/dL to 130 mg/dL), cholesterol levels (from 210 mg/dL to 180 mg/dL), and BMI (from 28.5 to 27.3), all with a statistical significance of P<0.01. Participants reporting “Good” or “Very Good” health increased from 45% to 65%, and those reporting regular physical activity increased from 25% to 45% (P<0.05). Hospitalizations/medical visits decreased from an average of 2.1–1.3 over 6 months (P<0.01). The proportion of participants with awareness of their medication's side effects significantly increased from 30% before the health education program to 70% afterwards (P<0.001). In addition, participants reporting adherence to dietary guidelines rose from 20% to 50% (P<0.01). Conclusion: Health education appears to have a substantial positive impact on medication adherence, biometric health outcomes, and overall well-being in low-income neighborhoods. Structured health education interventions may play a pivotal role in improving community health.

Re-defining Transport for London’s strategic neighbourhoods from spatial and social perspectives

Neighbourhoods are fundamental spatial units to present social phenomena in urban studies. Many studies use administrative boundaries such as census tracts as representations of neighbourhoods, but such boundaries may poorly represent the underlying social structures and physical attributes which might help define more vernacular conceptions and dialectical evolution of these zones. In this paper, using the goal of creating a new set of ‘Strategic Neighbourhoods’ for Transport for London (TfL) as vehicle for analysis, we evaluate two contrasting spatially and socially focused methodologies of neighbourhood generation. In comparing the outputs of a tertiary-communities (T-Communities) method and a combined Principal Component Analysis (PCA) and Minimum Spanning Tree (MST) cluster analysis method with an earlier iteration of Strategic Neighbourhoods defined by TfL, indices including neighbourhood size, intra-class correlation coefficient (ICC), and the number of community centres are calculated to evaluate their relative performance which demonstrate that both methods create neighbourhood boundaries that can better capture intra-group social homogeneity and are more suitable for analysis than the original SNA boundaries. These results are discussed in the context of the dialectic relationship between neighbourhood outcomes, spatial structures, and social characteristics, leading to more widely relevant conclusions that neighbourhood boundary delineation should combine spatial structure, social attributes, and experimental knowledge to effectively sub-divide urban activity.

Short-term impact of a neighbourhood-based intervention on mental health and self-rated health in Hamilton, Ontario, Canada.

The Hamilton Neighbourhoods Study aimed to measure the short-term impact of a neighbourhood-based intervention known as the City of Hamilton's Neighbourhood Action Strategy on health and neighbourhood outcomes. A quasi-experimental study with 881 intervention participants across six targeted neighbourhoods and 173 control participants was conducted to investigate changes in self-rated health and mental health from baseline to follow-up. There was evidence of small improvements in mental health in two neighbourhoods, but there was no change in self-rated health. Place-based interventions aimed at high poverty neighbourhoods may have only modest impacts on health in the short-term.

Co-Powering Solutions to Truck Pollution in South Stockton

Despite decades of literature and practice with community-engaged research along with advancements in the recognition of environmental injustices, the application of equity-/justice-based and collaborative approaches between government agencies and community-based organizations has been limited. The toxic legacies of environmental racism, redlining, displacement, and segregation combined with the accelerating human-caused climate crisis warrant an increased need for consultation and collaboration between frontline communities and power brokers to markedly improve quality of life and health outcomes in environmental justice neighborhoods. This paper describes the processes and progress to date from a community-led collaboration between local community-based organizations and the Enforcement Division of the California Air Resources Board to assess and address air pollution in South Stockton, particularly from heavy-duty diesel trucks. South Stockton is one of the most polluted neighborhoods in California’s San Joaquin Valley, one of the most disparate and polluted regions in the United States. Some of the most significant components integrated into this project thus far include taking an equity-, justice-, and youth-oriented approach to community development that intentionally emphasizes a historical understanding of root causes of social and environmental injustices and provides pathways to workforce development. Including these elements has been essential in building the trust necessary to transform disparate power relations between the state and environmental justice communities, and to put multiple ways of knowing into conversation with each other to co-learn and co-power solutions to air pollution in South Stockton.

Housing policy and linguistic profiling: An audit study of three American dialects

The 1968 Fair Housing Act protects consumers from discrimination based on membership in protected classes, such as their gender, race, and ability. There is a large gap, however, between what this policy seeks to protect and the lived experiences of certain individuals, since many listeners continue to link the production of non-Standard speech varieties with social stereotypes. In light of the findings of Purnell et al. (1999), who demonstrated that such judgments negatively affect housing access, this study was designed to determine if linguistic profiling remains observable in the contemporary housing market. Through an audit of ninety publicly listed rental properties in three demographically heterogeneous Knoxville, TN, neighborhoods, the study analyzed the effects of using three different American dialects: African American Language (AAL), Mainstream US English (MUSE), and Southern American (SA). A single, multidialectal speaker asked property managers questions about each unit and neighborhood. The outcomes were assessed in terms of (i) the caller’s success in gaining an appointment to view the property and (ii) the relation of dialect and neighborhood to the phenomenon of local prestige A key finding is that using non-Standard voices produces significantly better outcomes in neighborhoods with demographics that match those of the indexed social characteristics of the given non-Standard speech variety (e.g. Blackness with AAL in zip code 37914). Results from an attribute assessment are also reported, revealing how general listeners categorize and respond to speech used in the audit study. Analyses of attribute assessments reveal that three very different character profiles emerge from a single person’s speech varieties. These results have stark policy implications, as these linguistic profiles develop without listeners having made accurate or consistent identification of social information—like the race of the speaker—in their percepts. Federal antidiscrimination policy must be adjusted to protect individuals who experience voice-based oppression—in the housing market and across institutions. This study adds to the growing evidence such individuals can use to challenge FHA violations in voice-only contexts.*

Abstract 261: Association Of Neighborhood Social Determinants Of Health With Adverse Out-of-hospital Cardiac Arrest (OHCA) Outcomes Among Medicare Beneficiaries

Introduction: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death with prior studies demonstrated worse OHCA outcomes in neighborhoods with higher proportion of Blacks and lower socioeconomic status. The association between OHCA outcomes and other social determinants of health (SDOHs) like limited English proficiency (LEP) and education is not well studied. Hypothesis: We hypothesized patients living in neighborhoods with high proportion of LEP had worse OHCA outcomes. We chose survival to hospital admission as the primary outcome due to its proximity to reflect a neighborhood’s characteristics. Methods: We performed a two-level hierarchical logistic-regression model. Patient data were Medicare fee-for-service claims between January 1, 2013, and December 31, 2015 (level 1). Neighborhood characteristics for the area in which each OHCA occurred were derived from the 2014 American Community Survey at the ZCTA level (level 2). We identified six neighborhood SDOH predictors of interest including LEP, median household income, racial and ethnic-group composition, percent unemployment, less than high school education, and population density. Results: Among the 194,231 OHCA events identified, 60,760 (31.3%) survived to hospital admission. Contrary to our hypothesis, Patient who had a cardiac arrest in the highest proportion of LEP neighborhoods were more likely to survive to hospital admission as compared to those living in predominantly English-speaking neighborhoods (OR 1.16; 95% CI, 1.10 to 1.23). Household income, racial composition, and unemployment had no effect on the likelihood of survival to hospital admission in OHCA while education and population density appeared to be protective (Table) . Conclusions: In a large cohort study, we found that patients who had an out of hospital cardiac arrest were more likely to survive to hospital admission in higher LEP, higher education, and higher population density neighborhoods.

Salir Adelante: Social capital and resilience during the Covid-19 pandemic in Argentina.

The Covid-19 pandemic has stimulated new appraisals of how social cohesion, including neighborhood-level social capital, fosters resilience in the face of crisis. Several studies suggest better health outcomes in neighborhoods with higher level of social capital, in general and during the pandemic. Building on a growing body of research which suggests that those who live in close-knit neighborhoods have fared better during the pandemic, this article analyzes how social capital influences individual and collective perceptions and attitudes about the experiences of the Covid-19 pandemic in Tucumán, Argentina. To assess this question, we used a mixed-methods approach, combining focus groups, semi-structured interviews, and an online survey (n = 701 respondents) conducted in September 2021. We find widespread experiences of resilience in response to the Covid-19 pandemic, in spite of difficult socioeconomic conditions and perceived poor government performance. Results from logistic regression analysis indicate that perceptions of high neighborhood social capital are associated with more positive outcomes in many dimensions, including personal resilience, ability to cope with uncertainty, perceptions of community solidarity, and reported compliance with public health measures. We further argue that conceptualizations of social cohesion need to be adjusted to local or national-level cultural norms to accurately capture the experience of countries of the Global South.

The Effects of Rental Assistance Programs on Neighborhood Outcomes for U.S. Children: Nationwide Evidence by Program and Race/Ethnicity

Project-based housing programs and tenant-based housing programs (vouchers) may have differential effects on neighborhood outcomes for residents. Theoretically, vouchers should enhance access to low-poverty neighborhoods for low-income families thereby promoting economic mobility for children, though vouchers’ success may vary by race and ethnicity. Drawing on a national survey-administrative data linkage and a quasi-experimental approach, we examine the impact of project-based housing and vouchers on an index of socioeconomic neighborhood disadvantage among children. We find that living in project-based housing leads to greater exposure to neighborhood disadvantage while receiving vouchers leads to reduced exposure. Reductions in neighborhood disadvantage for children receiving vouchers are found only for non-Hispanic Black and Hispanic/Latino children. For non-White families, vouchers are associated with a reduced likelihood of living in high-poverty neighborhoods and increased likelihood of living in low-poverty neighborhoods, presenting an opportunity to narrow racial and ethnic differences in children's neighborhood attainment.

Abstract TMP47: Food Insecurity And Long Term Mortality Rates After Stroke In The US

Background: Around 50 million people in the US have inadequate access to nutritious food. Food insecurity is linked with chronic conditions and worse overall health. Research has shown that living in a lower SES neighborhood is linked to increased post-stroke mortality, but little is known about the effect of food insecurity on mortality. Methods: This study used the National Health and Nutrition Examination Survey (NHANES) dataset 1999/2000-2013/2014 with linked mortality files through 2015. Participants included those ≥ 20 years with a complete survey, physical examination, and mortality information. Stroke was self-reported. Food security was characterized as food secure (full, marginal) or food insecure (low, very low). We evaluated the relationship between food insecurity and all-cause, cardiovascular (CV) and stroke mortality in the general and stroke population using Cox proportional hazards regression models, adjusting for sociodemographic factors and comorbidities. Results: From 1999 to 2014, 40,777 people participated in NHANES and 1,530 reported a history of stroke. Prevalence of food insecurity was 11.6% in the general population and 15.5% in the stroke subset. Among the general population, there were 5394 deaths due to all-causes, 1152 CV deaths, and 216 stroke deaths. Among the stroke population, there were 650 deaths due to all-causes, 176 CV deaths, and 41 stroke deaths. In the general population, food insecure individuals had higher adjusted all-cause mortality (aHR 1.15, CI 1.01-1.32) and a trend towards higher CV (aHR 1.14, 0.85-1.52) and stroke mortality (aHR 1.23, 0.65-2.34). In participants with prior stroke, food insecurity had no impact on all-cause, CV or stroke mortality. Discussion: Although prior studies have demonstrated that living in a low SES neighborhood results in worse post-stroke mortality, this data suggests the effect is not directly linked with food insecurity. A potential explanation is that individuals may receive greater access to food resources after a stroke. There is also the possibility that the low frequency of deaths among stroke survivors limited the ability to detect an effect. Further study is needed to explore the underpinnings of worse post-stroke outcomes in lower SES neighborhoods.

Do health trajectories predict neighborhood outcomes? Evidence of health selection in a diverse sample of U.S. adults.

Across the United States, residents of lower income neighborhoods evince poorer health, on average, than residents of more affluent areas. Studies aiming to explain this pattern have focused largely on the effects of neighborhood characteristics on residents' health, often overlooking the possibility that the reverse causal process-that a person's health impacts where they live, or "health selection into neighborhoods"-also plays a role. We investigated processes of health selection using the Panel Study of Income Dynamics, a longitudinal survey of U.S. households. Using ordinary least squares linear regression, we estimated the effect of householders' self-rated health on their neighborhood socioeconomic status (SES, the Census tract-level family poverty rate) in 2013, adjusting for neighborhood SES and health in 2001 as well as sociodemographic characteristics and residential mobility. Poorer health was associated with residence in higher poverty neighborhoods overall. Stratified models indicated that while health selection was observed across both race/ethnicity and class boundaries, the relationship between poor health and neighborhood poverty was stronger among non-Hispanic Black respondents, those with low income, and respondents who either moved moderate distances or did not move at all during the study period. We conclude with a call for future work exploring the mechanisms leading those in worse health to reside in higher poverty neighborhoods, and for public health policies that seek not only to improve health supporting conditions in economically disadvantaged neighborhoods, but that also support the economic and social needs of residents struggling with health problems.

Twin Similarity for Neighborhood, Geographic Mobility, and Health Outcomes in Late Adulthood

Socioeconomic status (SES) is one of the most robust predictors of health. The source of SES-health associations is heavily debated; one approach is investigating neighborhood-level environmental characteristics. Challenges include selection effects and the possibility of reverse causation: people choose their neighborhoods. Longitudinal twin research can overcome these issues by assessing location choice over time as well as twin similarity; however, few existing twin studies have incorporated neighborhood-level data, and none of those focus on aging. Using longitudinal data from the Swedish Adoption/Twin Study of Aging, the current study examined the impact of location at various points in life. Location at birth and in 1993 were available for 972 participants. Birth years ranged from 1926 to 1948; mean age in 1993 was 54.55 (range = 35-67). Thirty-nine percent of the sample had moved to a different county between birth and midlife: individuals who moved had significantly higher parental SES and had achieved significantly higher education. Moreover, identical twin concordance for geographic mobility (77%) was significantly higher than fraternal twin concordance (65%), indicating a modest but significant genetic contribution. Geographic mobility did not impact identical twin similarity on a functional aging factor (corrected for age and education), but fraternal twins concordant for mobility were more similar than discordant twins, suggesting genetic contributions to mobility may also impact health. Ongoing retrieval of location information for twins born 1900-1925 and geocoding of location information available at 9 waves of data collection will allow for expanded investigation of the SES-health relationship at the neighborhood level.

GIScience and neighborhood change: Toward an understanding of processes of change

AbstractProcesses of neighborhood change are the result of the unfolding of events and decisions by multiple actors operating at varying spatial and temporal scales, enabled and constrained upon an unequal urban landscape. The contributions of GIScience toward understanding these processes have evolved from the simple mapping of static, cross‐sectional maps toward an embrace of novel data and methods that enable longitudinal trajectories to be extracted and neighborhood futures to be predicted. In this article, I review these advancements and chart a course forward that considers a future research agenda that is critically cognizant of the potentials and perils of new data sources and method, is representative of the full spectrum of processes operating both visibly and invisibly that give rise to observed neighborhood outcomes, and considers their varying spatial and temporal scales.

Neighborhood hotspot and community awareness: The double role of social network sites in local communities

Abstract There is a tendency in the literature on local digital media use and neighborhood outcomes to conceptualize Social Network Sites (SNSs) as mere transmission channels, thereby ignoring SNSs’ dynamics and limiting the understanding of their role in neighborhood life. Informed by Communication Infrastructure Theory and social media literature, we propose and test a model to investigate the association between the use of SNSs, appropriated as online neighborhood networks, and neighborhood sense of community. We administered a survey to Flemish online neighborhood network users (n = 590) and found that active localized SNS use brings about an online sense of community and community awareness, which both independently lead to a neighborhood sense of community. Based on these findings, we argue that SNSs, appropriated as online neighborhood networks, function simultaneously as neighborhood hotspots in a neighborhood’s communication action context as well as community awareness media in a neighborhood’s storytelling network.

Neighborhood Factors Associated with Racial/Ethnic Disparities in Achieving Sustained HIV Viral Suppression Among Miami-Dade County Ryan White Program Clients.

Racial/ethnic minorities are disproportionately affected by poor HIV care outcomes. Studies have also examined the effects of neighborhood-level factor on an individual's health outcomes. Thus, the objective of this study was to assess the effects of neighborhood factors on the association between race/ethnicity and sustained viral suppression (all viral load tests <200 copies/mL per year). Data for 6491 people with HIV in the 2017 Miami-Dade County Ryan White Program and neighborhood-level data by ZIP code tabulated areas from the American Community Survey were utilized. Multi-level logistic regression models were used to assess the role of neighborhood factors on the association between race/ethnicity and sustained viral suppression. Results show that non-Hispanic Blacks had lower odds of sustained viral suppression in low socioeconomic disadvantage [adjusted odds ratio (aOR): 0.39; 95% confidence interval (CI): 0.20-0.74], moderate residential instability (aOR: 0.31; 95% CI: 0.15-0.65), and low and high racial/language homogeneity neighborhoods (aOR: 0.38; 95% CI: 0.16-0.88) and (aOR: 0.38; 95% CI: 0.19-0.75), respectively, when compared to non-Hispanic Whites (NHWs). Haitians also exhibited poor outcomes in neighborhoods characterized by moderate residential instability (aOR: 0.42; 95% CI: 0.18-0.97) and high racial/language homogeneity (aOR: 0.49; 95% CI: 0.26-0.93), when compared to NHWs. In conclusion, disparities in rates of sustained viral suppression were observed for racial/ethnic minorities within various neighborhood-level factors. These findings indicate the importance of addressing neighborhood characteristics to achieve optimal care for minorities.

Esteem in Public Good Networks

We study properties of collective action problems bounded by minimal contributions as well as endowment and variable contributions are neighbourhood dependent. We relate nearness to non-interior agents and its implication for interior contribution. Here, we see the aspects of node distance to non-interior agents which have implications for interior agents. Endowments may be redistributed among agents. We highlight strict conditions for budget balanced transfers for which neighbourhood contributions and individual residual consumption's are invariant. Agents may or may not be concerned about neighbourhood outcomes. We find that welfare is self correcting and neither cases are relevant to the overall welfare impact of neutral transfers.

Rethinking the “buffering” theory of neighborhood racial transition

AbstractIn metropolitan areas with significant numbers of Latinx and Black people, Santiago (1991) hypothesized that Latinx groups may “buffer” white neighborhoods from Black ones. Farley and Frey (1994, https://doi.org/10.2307/2096131) subsequently suggested that Latinx and Asian groups provide a social or spatial “buffer” that enables White and Black neighborhood coresidence. In predominantly White spaces, increases in the neighborhood shares of Latinx and Asian populations moderates White resistance to the presence of Blacks, and this helps explain growing neighborhood racial diversity in the United States. This essay suggests expanding the thesis in several ways. We first consider reversing the theory wherein Latinx and Asian groups provide a “buffer” enabling White and Black coresidence because Blacks are cushioned from the actions of Whites. This view requires us to include not only White tolerance but also White intolerance in the buffering logic. Second, we point out that racially mixed neighborhoods may also come about because people want to live in such diverse environments. Third, this leads to a consideration of processes of neighborhood racial mixing that include the roles of real estate markets actors in shaping neighborhood outcomes as well as the motivations of Latinx, Asian, and mixed‐race populations.

Area Deprivation Index and Cardiovascular Events: CAN CARDIAC REHABILITATION MITIGATE THE EFFECTS?

Neighborhood socioeconomic status is associated with health outcomes. Cardiac rehabilitation (CR) provides a cost-effective, multidisciplinary approach to improve outcomes in cardiovascular disease. We aimed to evaluate the association of the Area Deprivation Index (ADI), a marker of neighborhood social composition, with risk of recurrent cardiovascular outcomes and assessed the modifying effect of CR. We identified patients with a primary diagnosis of (1) myocardial infarction or (2) incident heart failure (HF) admitted to a large-sized regional health center during 2010-2018. We derived the ADI from home addresses and categorized it into quartiles (higher quartiles indicating increased deprivation). We obtained number of CR visits and covariates from the health record. We compared rehospitalization (cardiovascular, acute coronary syndrome [ACS], and HF) and mortality rates across ADI quartiles. We included 6957 patients (age 69.2 ± 13.4 yr, 38% women, 89% White race). After covariate adjustment, the ADI was significantly associated with higher incidence rates (IRs)/100 person-yr of cardiovascular rehospitalization (quartile 1, IR 34.6 [95% CI, 31.2-38.2]; quartile 4, 41.5 [95% CI, 39.1-44.1], P < .001). In addition, the ADI was significantly associated with higher rates of rehospitalization for HF (P < .001), ACS (P < .012), and all-cause mortality (P < .04). These differences in rehospitalization and mortality rates by the ADI were no longer significant in those who attended CR. We found the increased ADI was adversely associated with rehospitalizations and mortality. However, in individuals with CR, outcomes were significantly improved compared with those with no CR. Our findings suggest that CR participation has the potential to improve outcomes in disadvantaged neighborhoods.

Urban mobile food truck policies: reducing disparities and building a culture of health in the United States.

We undertook this study knowing that for people throughout the Midwest who live in low-income urban neighborhoods, finding and affording healthy foods continues to be a problem. People with less money are not only forced to spend it on food, but have so limited options for avoiding purchase of foods with high levels of fat, salt, and sugar. A review of the literature shows that very little is known about how mobile food trucks can increase availability and affordability of healthy foods in low-income neighborhoods in the United States. We compared municipal codes regulating mobile food truck operators and evaluated the impact on cities in the Midwest for encouraging a ‘culture of health.’ We analyzed six Midwest metropolitan areas with the highest proportion of minorities who lived below the poverty level and had mobile food trucks selling provisions in their neighborhoods. We found that developing more incentives for mobile food truck operators to sell healthier food options can contribute to improving health outcomes in low-income neighborhoods.