Perceived Neighborhood Factors Research Articles

Positive Outliers: A Mixed Methods Study of Resiliency to Childhood Obesity in High-Risk Neighborhoods

ObjectiveDespite the high prevalence of obesity and the clustering of risk by neighborhood, few studies have examined characteristics which promote healthy child weight in neighborhoods with high obesity risk. We aimed to identify protective factors for children living in neighborhoods with high obesity risk. MethodsWe identified neighborhoods with high obesity risk using geolocated electronic health record data with measured body mass index (BMI) from well-child visits (2012–2017). We then recruited caregivers with children aged 5 to 13 years who lived in census tracts with mean child BMI percentile ≥72 (February 2020–August 2021). We used sequential mixed methods (quantitative surveys, qualitative interviews) to compare individual, interpersonal, and perceived neighborhood factors among families with children at a healthy weight (positive outliers [PO]) versus families with ≥1 child with overweight or obesity (controls). Regression models and comparative qualitative analysis were used to identify protective characteristics. ResultsSeventy-three caregivers participated in the quantitative phase (41% PO; 34% preferred Spanish) and twenty in the qualitative phase (50% PO; 50% preferred Spanish). The frequency of healthy caregiver behaviors was associated with being a PO (Family Health Behavior Scale Parent Score adjusted β 3.67; 95% CI 0.52–6.81 and qualitative data). Protective factors also included caregivers’ ability to minimize the negative health influences of family members and adhere to family routines. ConclusionsThere were few differences between PO and control families. Support for caregiver healthy habits and adherence to healthy family routines emerged as opportunities for childhood obesity prevention in neighborhoods with high obesity risk.

Perceived neighborhood factors, health behaviors, and related outcomes in the Hispanic Community Health Study/Study of Latinos

Hispanic/Latino populations may experience significant neighborhood disadvantage, but limited research has explored whether these factors affect their health behaviors. Associations between perceived neighborhood factors at Visit 1 and health behaviors and related outcomes at Visit 2 in the Hispanic Community Health Study/Study of Latinos were evaluated. Multivariable logistic regression assessed cross-sectional and longitudinal relationships between perceived neighborhood social cohesion (NSC, 5 items), and neighborhood problems (NP, 7 items), with cancer screening, current smoking, excessive/binge drinking, hypertension, obesity, physical activity, and poor diet by gender and birthplace. NSC and NP scores were converted into quartiles. Mean age of participants was 42.5 years and 62.1% were women. Perceived NP, but not perceived NSC, differed by gender (p < 0.001). In unstratified models, no significant associations were observed between perceived NSC and any health behavior, whereas greater perceived NP was associated with less adherence to colon cancer screening (moderate level: aOR = 0.68, 95% CI = 0.51, 090) and more physical activity (very high level: aOR = 1.34, 95% CI = 1.06, 1.69) compared to low perceived NP. Women with moderate perceived NP, versus low NP, had a lower odds of colon cancer screening at Visit 1 (aOR = 0.62, 95% CI = 0.43, 0.91) and higher odds of mammogram adherence at Visit 2 (aOR = 2.86, 95% CI = 1.44, 5.68). Men with high perceived NP had a higher odds of excessive or binge drinking at Visit 2 (aOR = 1.99, 95% CI = 1.19, 3.31). We conclude that perceived NP were significantly related to health behaviors among HCHS/SOL individuals. Perceptions of neighborhood environment may be considered modifiable factors of structural neighborhood environment interventions.

Pathways between objective and perceived neighborhood factors among Black breast cancer survivors

BackgroundMounting evidence supports associations between objective neighborhood disorder, perceived neighborhood disorder, and health, yet alternative explanations involving socioeconomic and neighborhood social cohesion have been understudied. We tested pathways between objective and perceived neighborhood disorder, perceived neighborhood social cohesion, and socioeconomic factors within a longitudinal cohort.MethodsDemographic and socioeconomic information before diagnosis was obtained at interviews conducted approximately 10 months post-diagnosis from participants in the Women’s Circle of Health Follow-up Study – a cohort of breast cancer survivors self-identifying as African American or Black women (n = 310). Neighborhood perceptions were obtained during follow-up interviews conducted approximately 24 months after diagnosis. Objective neighborhood disorder was from 9 items audited across 23,276 locations using Google Street View and scored to estimate disorder values at each participant’s residential address at diagnosis. Census tract socioeconomic and demographic composition covariates were from the 2010 U.S. Census and American Community Survey. Pathways to perceived neighborhood disorder were built using structural equation modelling. Model fit was assessed from the comparative fit index and root mean square error approximation and associations were reported as standardized coefficients and 95% confidence intervals.ResultsHigher perceived neighborhood disorder was associated with higher objective neighborhood disorder (β = 0.20, 95% CI: 0.06, 0.33), lower neighborhood social cohesion, and lower individual-level socioeconomic factors (final model root mean square error approximation 0.043 (90% CI: 0.013, 0.068)). Perceived neighborhood social cohesion was associated with individual-level socioeconomic factors and objective neighborhood disorder (β = − 0.11, 95% CI: − 0.24, 0.02).ConclusionObjective neighborhood disorder might be related to perceived disorder directly and indirectly through perceptions of neighborhood social cohesion.

Physical Activity Patterns and Neighborhood Characteristics of First-Generation Latina Immigrants Living in Arizona: Cross-sectional Study.

BackgroundMetabolic diseases, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Performing regular aerobic physical activity (PA) is a lifestyle behavior associated with the prevention and control of these conditions. However, PA levels of most Latina immigrants are below national guidelines. Neighborhood environmental factors may influence the PA levels of adults, but limited research has explored associations between the neighborhood environment and PA levels among Latina immigrants.ObjectiveThe objective of this study was to explore the PA patterns of first-generation US Latina immigrants and how neighborhood environmental factors are related to those PA patterns.MethodsUsing a cross-sectional study design, 50 first-generation Latina immigrants completed the International Physical Activity Questionnaire (IPAQ) and the Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: (1) walking environment, (2) aesthetic quality, (3) safety, (4) violence, (5) social cohesion, and (6) activities with neighbors. Median self-reported metabolic equivalent (MET)-minutes/week of PA were used to summarize domain-specific (ie, work, domestic/household, leisure, and transportation) and intensity-specific (ie, walking, moderate, vigorous, moderate to vigorous) PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (ie, dichotomous outcome of some versus no leisure-time PA), transportation PA (ie, dichotomous outcome of some versus no transportation PA), and meeting national PA guidelines (ie, dichotomous outcome of meeting versus not meeting guidelines).ResultsPreliminary analyses showed that 10 participants reported excessively high PA levels and 1 participant had incomplete PA data; these women were excluded from analyses based on IPAQ scoring guidelines. The remaining 39 participants (mean age 40.5 years; mean length of US residency 4.6 years) reported a median of 4512 MET-minutes/week of total PA. The majority of PA was acquired through domestic activities (median 2160 MET-minutes/week), followed by leisure-time PA (median 396 MET-minutes/week), transportation PA (median 198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models indicated that the neighborhood factors of walking environment, aesthetic quality, and safety were positively associated with engaging in leisure-time PA (odds ratios of 5.95, 95% CI 1.49-23.74; 2.45, 95% CI 1.01-5.93; and 3.30, 95% CI 1.26-8.67, respectively) and meeting national PA guidelines (odds ratios of 4.15, 95% CI 1.13-15.18; 6.43, 95% CI 1.45-28.39; and 2.53, 95% CI 1.00-6.36, respectively). The neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes.ConclusionsAlthough most participants met national PA guidelines (ie, ≥500 MET-minutes/week of moderate-to-vigorous PA), the majority of their PA was achieved through domestic activities, with limited leisure, transportation, and work PA. Given that leisure-time PA in particular plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure-time PA intervention. Such interventions should consider neighborhood environmental influences, as these factors may serve as determinants of PA.

The effects of neighborhood factors, maternal depression and parental emotional support on social – behavioral outcomes of children involved in the child welfare system

ABSTRACT Children involved in the child welfare system (CWS) are exposed to various negative neighborhood and family-level factors contributing to their poor developmental outcomes, including poor social-behavioral health. Considering the importance of social-behavioral functioning for children’s cognitive growth and academic success, it is important that the interplay of neighborhood and family-level factors and their effects on the social-behavioral outcomes of at-risk children are well understood. By utilizing the first two waves of nationally representative data from the National Survey of Child Adolescent Well-Being (NSCAW II), the study examines the potential direct and indirect effects of mothers’ perceived neighborhood factors on the social-behavioral outcomes of young children involved in the CWS. Hypothesized direct and indirect pathways operating through mediating mechanisms such as maternal mental health, parental responsiveness, and harsh discipline were tested by using structural equation modeling (SEM). The results suggest that perceived neighborhood danger is significantly related to mothers’ depressive symptoms, increasing the likelihood of harsh and negative parenting being used by depressed mothers, ultimately resulting in negative social-behavioral outcomes of young children in the CWS.

Community participation and neighborhood factors associated with physical and mental health among low-income mothers in the United States

ABSTRACT Religious and social participation and neighborhood factors have been associated with health outcomes. Because depression and physical health problems are common among mothers, we sought to understand whether participation would be associated with more favorable health outcomes when accounting for neighborhood factors: disorder, social cohesion, and informal social control. Using Fragile Families and Wellbeing Study data (N = 2,926) we ran logistic regression models to estimate the relationships between depression, physical health, community participation, and perceived neighborhood factors. Neither religious nor social participation was significant in the models. However, the odds of meeting the criteria for depression were 1.20 times (95% CI [1.05, 20 1.37]) higher among mothers’ reporting higher neighborhood disorder. Neighborhood social cohesion was inversely associated with depression; higher neighborhood disorder was associated with decreased favorable health. Findings provide further evidence that interpersonal factors may be insufficient to overcome the detrimental effects of community-level factors.

Moderating Effects of Perceived Neighborhood Factors on Intimate Partner Violence, Psychological Distress, and Suicide Risk.

Neighborhood factors such as instability and weakened social ties have been linked to both intimate partner violence (IPV) and poor mental health outcomes; however, research has not yet investigated the relationship between IPV and gentrification-specific change, including whether gentrification-related neighborhood factors affect mental health symptoms commonly associated with IPV. This study aims to determine if (a) perceptions of neighborhood connectedness and recent compositional changes (e.g., residential mobility, crime, and infrastructure) are associated with IPV exposure and (b) perceived neighborhood connectedness and compositional change moderates the relationship between IPV and mental health symptoms (i.e., psychological distress, suicidal ideation, suicide attempts). Data from the 2017 Survey of Police-Public Encounters were used, which is an online, cross-sectional, general population survey administered to male and female adults residing in New York City and Baltimore (N = 1,000). Findings suggest that higher levels of neighborhood disconnectedness were associated with higher levels of IPV, whereas higher levels of neighborhood compositional change were associated with lower levels of IPV. Neighborhood disconnectedness and compositional change worsened psychological distress symptoms and suicide risk most strongly among individuals exposed to IPV. Violence prevention and intervention approaches should consider the extent to which neighborhood instability, related to community connectedness and recent compositional change, impacts the safety and mental health of victims of IPV.

Cultural Stress, Emotional well-being, and Health Risk Behaviors among Recent Immigrant Latinx families: The Moderating Role of Perceived Neighborhood Characteristics

Latinx families can experience cultural stressors, which can negatively influence their emotional and behavioral health. Few studies have examined if perceived neighborhood characteristics buffer against or exacerbate the negative effects of cultural stress on adolescent and parent health outcomes. To address this gap in the literature, this study investigated how parent (social cohesion, informal social control, extent of problems) and adolescent (support) perceived neighborhood factors moderated the associations of parent and adolescent cultural stress with parent and adolescent emotional and behavioral well-being. Data came from waves 1 and 3 of a six-wave longitudinal survey with 302 recent immigrant Latinx adolescents (47% female, Mage = 14.51 years) and their parents (74% mothers, Mage = 41.09 years). Results indicated that when parents reported low levels of neighborhood problems, adolescent cultural stress did not predict adolescent health risk behaviors. However, adolescent and parent cultural stress predicted higher levels of adolescents' sense of hope when parents perceived low levels of neighborhood problems. Furthermore, adolescent and parent cultural stress predicted higher youth depressive symptoms and health risk behaviors when positive neighborhood factors (informal social control, social cohesion) were high. Similarly, adolescent and parent cultural stress predicted lower adolescents' sense of hope and self-esteem when positive neighborhood factors were high. These findings indicate that efforts to reduce the negative effects of cultural stress on youth emotional and behavioral health may benefit from combating neighborhood problems. Results further indicate that research is needed to clarify unexpected findings. Directions for future research are discussed.

Perceived Neighborhood Quality and Cancer Screening Behavior: Evidence from the Survey of the Health of Wisconsin.

Socioeconomic disparities in colorectal and breast cancer screening persist, partially accounting for disparities in cancer outcomes. Some neighborhood characteristics--particularly area level socioeconomic factors--have been linked to cancer screening behavior, but few studies have examined the relationship between perceived neighborhood quality and screening behavior, which may provide more insight into the ways in which neighborhood environments shape cancer related behaviors. This study examines the relationship between several aspects of the perceived neighborhood environment and breast and colorectal cancer screening behavior among a population-based sample of Wisconsin residents. A sub-goal was to compare the relevance of different perceived neighborhood factors for different screening tests. This is a cross-sectional study of 2008-2012 data from the Survey of the Health of Wisconsin, a population-based annual survey of Wisconsin residents. An average risk sample of Black, Hispanic and White women age 50 and older (n = 1265) were selected. Survey regression analyses examined predictors of screening, as well as adherence to screening guidelines. Models controlled for individual socio-demographic information and insurance status. Perceptions of social and physical disorder, including fear of crime and visible garbage, were associated with screening rates. Findings emphasize the particular importance of these factors for colorectal cancer screening, indicating the necessity of improving screening rates in areas characterized by social disorganization, crime, and physical disorder. Additional work should be done to further investigate the pathways that explain the linkage between neighborhood conditions, perceived neighborhood risks and cancer screening behavior.

Associations between neighborhood perceptions and mental well-being among older adults

This study examined whether perceived neighborhood factors were associated with positive well-being in older adults using data from the English Longitudinal Study of Ageing. Neighborhood perceptions were assessed at baseline (2006/2007) and three measures of well-being – hedonic, eudaimonic and evaluative – were assessed at baseline and follow-up (2010/2011) for 6134 participants. In cross-sectional and longitudinal analyses, negative neighborhood perceptions were associated with poorer well-being on all three measures. These associations remained significant after adjusting for a range of sociodemographic and health status variables and depressive symptoms.

Changes in the perceived neighborhood environment in relation to changes in physical activity: A longitudinal study from childhood into adolescence

The aim was to investigate how physical activity and the perceived neighborhood environment in children change when they enter adolescence. Also the relation between changes in the perceived environment and changes in children’s physical activity was investigated. In total, 321 children and one of their parents filled out a physical activity questionnaire and the NEWS-Y at two time points (last grade of elementary school and 2 years later). Children also wore an activity monitor. Changes in children’s physical activity were dependent on the physical activity domain. Only less than half of children’s perceived neighborhood factors changed and about half of the parental perceived neighborhood factors changed. Most of these factors changed towards higher activity friendliness. Changes in the perceived environment were only limitedly related to changes in children’s physical activity.

Neighborhood socioeconomic deprivation, perceived neighborhood factors, and cortisol responses to induced stress among healthy adults

Associations between measures of neighborhood socioeconomic deprivation and health have been identified, yet work is needed to uncover explanatory mechanisms. One hypothesized pathway is through stress, yet the few studies that have evaluated associations between characteristics of deprived neighborhoods and biomarkers of stress are mixed. This study evaluated whether objectively measured neighborhood socioeconomic deprivation and individual perceived neighborhood characteristics (i.e. social control and fear of crime) impacted cortisol responses to an induced stressor among older healthy adults. Data from Heart Scan, a sub-study of the Whitehall II cohort, were used to generate multilevel piecewise growth-curve models of cortisol trajectories after a laboratory stressor accounting for neighborhood and demographic characteristics. Neighborhood socioeconomic deprivation was significantly associated with individual perceptions of social control and fear of crime in the neighborhood while an association with blunted cortisol reactivity was only evidence among women. Social control was significantly associated with greater cortisol reactivity and mediation between neighborhood socioeconomic deprivation and cortisol reactivity was suggested among women. These findings support a gender-dependent role of neighborhood in stress process models of health.

Investigating the Roles of Neighborhood Environments and Housing-Based Social Support in the Relocation of Persons Made Homeless by Hurricane Katrina

This study examined whether social support tied to relocation efforts and neighborhood social climate may mediate the effects of stressful life events on mental health outcomes following Hurricane Katrina. Participants were 108 adult persons made homeless by Hurricane Katrina and evacuated to Columbia, South Carolina. Civic leaders developed an intervention model that emphasized (a) a one-stop point of entry, (b) living in hotels and apartments rather than shelters, and (c) matching hotels with volunteer “hosts” to assist in relocation efforts. Results revealed that perceived neighborhood factors and satisfaction with host relationship were related to several mental health outcomes. Neighborhood social climate partially mediated several mental health outcomes. Implications of this intervention model and the utility of social ecological perspectives on homelessness interventions are discussed.

Socioeconomic Status, Environmental and Individual Factors, and Sports Participation

To examine the contribution of neighborhood, household, and individual factors to socioeconomic inequalities in sports participation in a multilevel design. Data were obtained by a large-scale postal survey among a stratified sample of the adult population (age 25-75 yr) of Eindhoven (the fifth-largest city of the Netherlands) and surrounding areas, residing in 213 neighborhoods (N = 4785; response rate 64.4%). Multilevel logistic regression analyses were performed with sports participation as a binary outcome (no vs yes); that is, respondents not doing any moderate- or high-intensity sports at least once a week were classified as nonparticipants. Unfavorable perceived neighborhood factors (e.g., feeling unsafe, small social network), household factors (material and social deprivation), and individual physical activity cognitions (e.g., negative outcome expectancies, low self-efficacy) were significantly associated with doing no sports and were reported more frequently among lower socioeconomic groups. Taking these factors into account reduced the odds ratios of doing no sports among the lowest educational group by 57%, from 3.99 (95% CI, 2.99-5.31) to 2.29 (95% CI, 1.70-3.07), and among the lowest income group by 67%, from 3.02 (95% CI, 2.36-3.86) to 1.66 (95% CI, 1.22-2.27). A combination of neighborhood, household, and individual factors can explain socioeconomic inequalities in sports participation to a large extent. Interventions and policies should focus on all three groups of factors simultaneously to yield a maximal reduction of socioeconomic inequalities in sports participation.