Residents Of Disadvantaged Neighborhoods Research Articles

Landscape Preference Evaluation of Old Residential Neighbourhoods: A Case Study in Shi Jiazhuang, Hebei Province, China

Landscape preference and cognition are essential in determining the external environment’s subjective reflections. Although much research has been conducted on landscape preferences, there is still a lack of information on landscape perceptions and preferences among residents of disadvantaged neighbourhoods, especially in Chinese cities. Taking old residential neighbourhoods of Shijiazhuang as an example, this paper used a large-scale questionnaire survey and semi-structured interviews to determine the landscape preference of the residents of old residential neighbourhoods for the community green spaces using the virtual model method. The chi-square test method is used to explore the inner logic of aesthetic preference from two aspects: landscape characteristics and socio-demographic characteristics. The respondents are 668 residents of old residential neighbourhoods (300 males, 368 females) distributed in four larger communities in the main urban area of Shijiazhuang. Random sampling and volunteer sampling were used to choose the survey respondents. The results showed this: (1) In terms of soft landscapes, respondents prefer natural planting, spaces with very high plant richness and high green coverage. In terms of hard landscapes, there is a preference for fitness and leisure facilities, rubber floors and a slight preference for water features and decorative landscape elements. (2) From the chi-square results, age significantly affects landscape preference, gender and education level. In contrast, marital status and occupation have no significant effect on landscape preference. The expression of the landscape preference of the residents of old residential neighbourhoods reflects the needs for functionality, reality and local concept. The main aim of this study is to fully understand the landscape preferences of residents in old residential neighbourhoods when using green space, and to find out what factors will affect residents’ landscape preferences. The research results have guiding significance for rationally improving the landscape planning, design and management of old residential neighbourhoods, and at the same time make up for the lack of international research on landscape preferences of disadvantaged communities. Improving the environment of old residential neighbourhoods can develop a higher sense of security, happiness and satisfaction among the residents.

Neighbourhood socioeconomic disadvantage and body size in Australia's capital cities: The contribution of obesogenic environments.

Residents of socioeconomically disadvantaged neighbourhoods have higher rates of overweight and obesity and chronic disease than their counterparts from advantaged neighbourhoods. This study assessed whether associations between neighbourhood disadvantage and measured body mass index (BMI) and waist circumference, are accounted for by obesogenic environments (i.e., residential distance to the Central Business District [CBD], supermarket availability, access to walkable destinations). The study used 2017-18 National Health Survey data for working-aged adults (aged ≥18 years, n = 9,367) residing in 3,454 neighbourhoods across Australia's state and territory capital cities. In five of eight cities (i.e., Sydney, Melbourne, Brisbane, Adelaide, and Perth) residents of disadvantaged neighbourhoods had significantly higher BMI and a larger waist circumference than residents of more advantaged areas. There was no association between neighbourhood disadvantage and body size in Hobart, Darwin, and Canberra. Associations between neighbourhood disadvantage and body size were partially explained by neighbourhood differences in distance to the CBD but not supermarket availability or walkable amenities. The results of this study point to the role of urban design and city planning as mechanisms for addressing social and economic inequities in Australia's capital cities, and as solutions to this country's overweight and obesity epidemic and associated rising rates of chronic disease.

Association of Race and Area Deprivation With Breast Cancer Survival Among Black and White Women in the State of Georgia

Increasing evidence suggests that low socioeconomic status and geographic residence in disadvantaged neighborhoods contribute to disparities in breast cancer outcomes. However, little epidemiological research has sought to better understand these disparities within the context of location. To examine the association between neighborhood deprivation and racial disparities in mortality among Black and White patients with breast cancer in the state of Georgia. This population-based cohort study collected demographic and geographic data from patients diagnosed with breast cancer between January 1, 2004, and February 11, 2020, in 3 large health care systems in Georgia. A total of 19 580 patients with breast cancer were included: 12 976 from Piedmont Healthcare, 2285 from Grady Health System, and 4319 from Emory Healthcare. Data were analyzed from October 2, 2020, to August 11, 2022. Area deprivation index (ADI) scores were assigned to each patient based on their residential census block group. The ADI was categorized into quartile groups, and associations between ADI and race and ADI × race interaction were examined. Cox proportional hazards regression models were used to compute hazard ratios (HRs) and 95% CIs associating ADI with overall mortality by race. Kaplan-Meier curves were used to visualize mortality stratified across racial and ADI groups. Of the 19 580 patients included in the analysis (mean [SD] age at diagnosis, 58.8 [13.2] years), 3777 (19.3%) died during the course of the study. Area deprivation index contributed differently to breast cancer outcomes for Black and White women. In multivariable-adjusted models, living in a neighborhood with a greater ADI (more deprivation) was associated with increased mortality for White patients with breast cancer; compared with the ADI quartile of less than 25 (least deprived), increased mortality HRs were found in quartiles of 25 to 49 (1.22 [95% CI, 1.07-1.39]), 50 to 74 (1.32 [95% CI, 1.13-1.53]), and 75 or greater (1.33 [95% CI, 1.07-1.65]). However, an increase in the ADI quartile group was not associated with changes in mortality for Black patients with breast cancer (quartile 25 to 49: HR, 0.81 [95% CI, 0.61-1.07]; quartile 50 to 74: HR, 0.91 [95% CI, 0.70-1.18]; and quartile ≥75: HR, 1.05 [95% CI, 0.70-1.36]). In neighborhoods with an ADI of 75 or greater, no racial disparity was observed in mortality (HR, 1.11 [95% CI, 0.92-1.36]). Black women with breast cancer had higher mortality than White women in Georgia, but this disparity was not explained by ADI: among Black patients, low ADI was not associated with lower mortality. This lack of association warrants further investigation to inform community-level approaches that may mitigate the existing disparities in breast cancer outcomes in Georgia.

Relationship Between Neighborhood Socioeconomic Disadvantage and Severe Maternal Morbidity and Maternal Mortality.

Rates of severe maternal morbidity and maternal mortality (SMM/MM) in the United States are rising. Disparities in SMM/MM persist by race, ethnicity and geography, and could partially be attributed to social determinants of health. Utilizing data from the largest, statewide referral hospital in Alabama, we investigated the relationship between residence in disadvantaged neighborhoods and SMM/MM. Data on all pregnancies between 2010 and 2020 were included; SMM/MM cases were identified using CDC definitions. Area deprivation index (ADI) available at the census-block group was geographically linked to individual records and categorized using quintile cutoffs; higher ADI score indicated higher socioeconomic disadvantage. Generalized estimating equation models were used to adjust for spatial autocorrelation and ORs were computed to evaluate the relationship between ADI and SMM/MM, adjusted for covariates including age, race, insurance, residence in medically underserved areas/population (MUAP), and urban/rural residence. Overall, 32,909 live-birth deliveries were identified, with a prevalence of 9.8% deliveries with SMM/MM with blood transfusion and 5.3% without blood transfusion, respectively. Increased levels of ADI were associated with increased odds of SMM/MM. Compared to women in the lowest quintile, the adjusted OR for SMM/MM among women in highest quintile was 1.78 (95%CI, 1.22-2.59, P=.0027); increasing age, non-Hispanic Black, government insurance and residence in MUAP were also significantly associated with increased odds of SMM/MM. Our results suggest that residence within disadvantaged neighborhoods may contribute to SMM/MM even after adjusting for patient-level factors. Measures such as ADI can help identify the most vulnerable populations and provide points to intervene.

Plan for healthy neighborhoods to improve mental wellbeing: a pilot study in Fresno, California

By using data collected from a self-administered survey, this study evaluates the variation of mental wellbeing between individuals and neighborhoods and its personal and neighborhood determinants in Fresno, California. It reveals the disparities of mental wellbeing, physical activity, and neighborhood environment between disadvantaged and non-disadvantaged neighborhoods in Fresno. Residents in disadvantaged neighborhoods report slightly lower levels of mental wellbeing and physical activity, significantly weaker neighborhood social capital, and much lower neighborhood environment quality. Our path analysis suggests that outdoor physical activity and perceived neighborhood social capital are the only two factors that influence mental wellbeing after controlling for personal socioeconomics and personality. Neither perceived nor objectively measured neighborhood environmental factors show significant and direct impacts on mental wellbeing. Neighborhood environment, however, shows indirect associations with mental wellbeing through their correlations with outdoor physical activity and perceived neighborhood social capital.

The association between social integration and neighborhood dissatisfaction and unsafety: a cross-sectional survey study among social housing residents in Denmark

BackgroundSocial integration and perceived neighborhood environment are recognized as important social determinants of health. However, little is known about the association between social integration and perceived neighborhood environment among underrepresented population groups, such as residents in disadvantaged neighborhoods, in public health research. The aim of this study is to: 1) Describe the levels of social integration and 2) Investigate the association between social integration and neighborhood dissatisfaction and unsafety among middle-aged and older social housing residents.MethodsA multilingual face-to-face interviewer-administrated survey questionnaire was conducted among 206 residents aged 45 years and above (response rate: 34.1%) of various nationalities in disadvantaged socioeconomic positions in a social housing area in Denmark. The assessment of social integration was based on cohabitation status, frequency of face-to-face and non-face-to-face interaction with social relations and participation in local association activities. Neighborhood dissatisfaction measured the level of dissatisfaction with the neighborhood, and neighborhood unsafety assessed the level of unsafety being outdoors in the neighborhood. Descriptive statistics were conducted to illustrate respondent characteristics and the distribution of social integration among the study population. Logistic regression models were applied to analyze associations between social integration and neighborhood dissatisfaction and unsafety, adjusted for age, sex, country of origin, educational attainment and employment status.ResultsIn total, 23.8% of the respondents reported low levels of social integration. A medium level of social integration was associated with higher odds of neighborhood dissatisfaction (OR: 2.36; 95% CI: 1.04–5.38) compared to the highest level of integration. A low frequency of face-to-face interaction was associated with higher odds of neighborhood dissatisfaction (OR: 2.65; 95% CI: 1.16–6.06) and neighborhood unsafety (OR: 2.41; 95% CI: 1.04–5.57) compared to the highest frequency of face-to-face interaction.ConclusionsAlmost one-fourth of respondents reported low levels of social integration. A medium level of social integration was associated with neighborhood dissatisfaction. A low frequency of face-to-face interaction was associated with neighborhood dissatisfaction and unsafety. The results suggest that targeted health promotion interventions designed to foster face-to-face interaction, hold potential to reduce neighborhood dissatisfaction and unsafety among residents in disadvantaged neighborhoods.

The usage, constraints and preferences of green space at disadvantage neighborhood: A review of empirical evidence

Neighborhood green space is closely related to the lives of every city dweller. However, some evidence showed that residents in disadvantaged neighborhoods do not fully use the green space due to quality, safety, and distance issues. Therefore, it is essential to understand how disadvantaged groups interact and use green space in these communities. However, there is still a lack of comprehensive evaluation. This research systematically sorts out the relevant literature and collects various attributes of the use, constraints, and preferences of the residents of disadvantaged neighborhoods on the green space through a systematic review method from the perspective of social ecology. Through a literature review of 4 databases (Science Direct, Scopus, web of science, and CNKI), 42 articles (N = 42) were finally included. This article concerns peer-reviewed papers published between 2008 and 2021. The research results showed that residents of disadvantaged communities' use of nearby green space are affected by personal, social, physical, and other attributes. Finally, a conceptual framework for the use, constraints, and preferences of disadvantaged neighborhood green space is proposed to help planners and designers design and improve community green space more effectively and ultimately achieve a harmonious living environment that meets various needs.

Association Between Neighborhood Disadvantage and Fertility Among Pregnancy Planners in the US

Decades of inequitable policies in the US have yielded disparities in neighborhood quality, and some studies show that living in a socioeconomically disadvantaged neighborhood is associated with worse health outcomes, including reproductive health outcomes. However, no US studies to date have directly examined the association between residence in disadvantaged neighborhoods and fertility. To examine the association between residence in disadvantaged neighborhoods and fecundability, a sensitive marker of fertility with many health implications. This prospective preconception cohort study used the Pregnancy Study Online, for which baseline data were collected from June 19, 2013, through April 12, 2019. The study included 6356 participants who identified as female, were 21 to 45 years of age, were attempting conception without fertility treatment, and provided a valid residential address in the contiguous US at enrollment. A standardized area deprivation index (ADI) derived at the census block group level applied to each residential address. Fecundability, the per-cycle probability of conception, via questionnaires that were completed every 8 weeks for 12 months, until conception or a censoring event. Proportional probabilities models were used to estimate fecundability ratios and 95% CIs for associations between ADI and fecundability. Restricted cubic splines were also implemented to examine nonlinearity. Models were adjusted for demographic characteristics and factors associated with fertility. The study's a priori hypothesis was that higher levels of neighborhood disadvantage would be associated with decreased fecundability. Among 6356 participants, 3725 pregnancies were observed for 27 427 menstrual cycles of follow-up. The mean (SD) baseline age was 30.0 (4.1) years, and most participants were non-Hispanic White (5297 [83.3%]) and nulliparous (4179 [65.7%]). Comparing the top and bottom deciles of disadvantaged neighborhood status, adjusted fecundability ratios were 0.79 (95% CI, 0.66-0.96) for national-level ADI rankings and 0.77 (95% CI, 0.65-0.92) for within-state ADI rankings. Restricted cubic splines showed some evidence of nonlinearity in the association. Associations were slightly stronger among participants with lower annual incomes (<$50 000). In this cohort study, residence in a socioeconomically disadvantaged neighborhood was associated with moderately decreased fecundability. If confirmed in other studies, these results suggest that investments to reduce disadvantaged neighborhood status may yield positive cobenefits for fertility.

Inequities in Community Exposure to Deadly Gun Violence by Race/Ethnicity, Poverty, and Neighborhood Disadvantage among Youth in Large US Cities

Understanding the burden of gun violence among youth is a public health imperative. While most estimates are based on direct and witnessed victimization, living nearby gun violence incidents may be consequential too. Yet detailed information about these broader experiences of violence is lacking. We use data on a population-based cohort of youth merged with incident-level data on deadly gun violence to assess the prevalence and intensity of community exposure to gun homicides across cross-classified categories of exposure distance and recency, overall and by race/ethnicity, household poverty, and neighborhood disadvantage. In total, 2–18% of youth resided within 600 m of a gun homicide occurring in the past 14–365 days. These percentages were 3–25% for incidents within 800 m and 5–37% for those within a 1300-m radius. Black and Latinx youth were 3–7 times more likely, depending on the exposure radius, to experience a past-year gun homicide than white youth and on average experienced incidents more recently and closer to home. Household poverty contributed to exposure inequities, but disproportionate residence in disadvantaged neighborhoods was especially consequential: for all racial/ethnic groups, the difference in the probability of exposure between youth in low vs high poverty households was approximately 5–10 percentage points, while the difference between youth residing in low vs high disadvantage neighborhoods was approximately 50 percentage points. Given well-documented consequences of gun violence exposure on health, these more comprehensive estimates underscore the importance of supportive strategies not only for individual victims but entire communities in the aftermath of gun violence.

Epigenetic Predictors of Mortality and Neighborhood Disadvantage

BACKGROUND AND AIM: Neighborhood characteristics are strongly associated with mortality even in geographically restricted urban areas, i.e. within a single city. Accelerated epigenetic aging and mortality risk present a lens through which to quantify impacts of the neighborhood environment on health and wellness. These biomarkers may also be useful indicators of sensitivity to environmental METHODS: We examined associations between the built environment and epigenetic biomarkers of aging and mortality risk in an urban, majority Black population of Detroit, MI. Associations were adjusted for relevant confounders, evaluated in sex-stratified models, and examined for alteration by study participant's perception of their neighborhood. We examined greenspace as a possible beneficial neighborhood factor. In separate analyses, we examined if epigenetic aging biomarkers are indicators of sensitivity to air pollution in an urban population of central North Carolina. RESULTS:We observed significant associations between the built environment in each neighborhood and multiple epigenetic biomarkers of aging. These associations indicated that residence in disadvantaged neighborhoods accelerated the aging process and increased mortality risk. Associations were often stronger amongst women than men and were not impacted by individual neighborhood perception. Greenspace appeared to be a protective factor. In separate analyses, we observed that accelerated epigenetic aging increases health risks from traffic-related air pollution. CONCLUSIONS:Neighborhood environmental characteristics are determinants of longevity and this may be reflected in aging biomarkers. These biomarkers have the potential to serve as both early indicators of health deterioration and indicators of beneficial environmental interventions, such as increasing greenspace. As these biomarkers may also be indicators of elevated environmental health risks, they may be indicative of relationships between neighborhood environmental factors whereby negative built environmental factors accelerate epigenetic aging thereby increasing both mortality risks and sensitivity to other environmental exposures such as air pollution. This abstract does not necessarily represent EPA policy. KEYWORDS: built environment, epigenetics, disadvantaged neighborhoods, social determinants of health, epigenetic aging, mortality biomarkers

Perceived neighborhood disorder and frequency of marijuana use among emerging adult African American females

Emerging adult African American females are at increased risk for cannabis use disorders. Ecological models suggest that African Americans’ increased risk for substance use disorders and associated adverse outcomes may result from chronic exposure to contextual disadvantages, such as living in economically deprived and disorganized communities. However levels of vulnerability for developing cannabis use disorders vary, even among residents of disadvantaged neighborhoods. Therefore, studies focused on within group differences are necessary. This study examined the relationship between frequency of marijuana use and perceived neighborhood disorder. The sample included 117 African American emerging adult females (Mage = 23.6 ± 3.4). After providing informed consent, participants completed a semi-structured interview that included the Neighborhood Environment Scale and a self-report measure of marijuana use. Additionally, participants provided a urine sample that was tested for the presence of psychoactive drugs. 46% tested positive for marijuana and 45% reported using marijuana in the past 30 days. 27% reported frequent/heavy use. Results from multinomial logistic regression analysis indicated a significant relationship between perceived neighborhood disorder and heavy marijuana use (AOR = 3.3; 95% CI = 1.06 − 10.29). Findings suggest African American emerging adult female residents of economically disadvantaged neighborhoods who appraise their environments as disorganized may be at heighten risk for problematic marijuana use and should be targeted for intervention. Moreover, the findings support the need for multi-systems interventions. As policy makers consider the legalization of marijuana, it is important that differences in marijuana use behaviors and negative outcomes across groups and contexts are taken into consideration.

Alcohol-Related Disparities Among Women: Evidence and Potential Explanations.

Although research on alcohol-related disparities among women is a highly understudied area, evidence shows that racial/ethnic minority women, sexual minority women, and women of low socioeconomic status (based on education, income, or residence in disadvantaged neighborhoods) are more likely to experience alcohol-related problems. These problems include alcohol use disorder, particularly after young adulthood, and certain alcohol-related health, morbidity, and mortality outcomes. In some cases, disparities may reflect differences in alcohol consumption, but in other cases such disparities appear to occur despite similar and possibly lower levels of consumption among the affected groups. To understand alcohol-related disparities among women, several factors should be considered. These include age; the duration of heavy drinking over the life course; the widening disparity in cumulative socioeconomic disadvantage and health in middle adulthood; social status; sociocultural context; genetic factors that affect alcohol metabolism; and access to and quality of alcohol treatment services and health care. To inform the development of interventions that might mitigate disparities among women, research is needed to identify the factors and mechanisms that contribute most to a group’s elevated risk for a given alcohol-related problem.

The potential for walkability to narrow neighbourhood socioeconomic inequalities in physical function: A case study of middle-aged to older adults in Brisbane, Australia.

Residents of disadvantaged neighbourhoods have poorer physical function than their advantaged counterparts, although the reasons for this remain largely unknown. We examined the moderating effects of walkability in the relationship between neighbourhood disadvantage and physical function using 2013 cross-sectional data from 5115 individuals aged 46-72 living in 200 neighbourhoods in Brisbane, Australia. The relationship between neighbourhood disadvantage and physical function differed by levels of walkability: positive associations as levels of walkability increased for those living in more disadvantaged neighbourhoods, and no difference for those living in more advantaged neighbourhoods. Further work is required to better understand the underlying mechanisms.

Socioeconomic factors associated with diet quality and meeting dietary guidelines in disadvantaged neighborhoods in the Southeast United States

ABSTRACT Objective: To examine diet quality and dietary intake among residents of disadvantaged neighborhoods in the Southeast United States (U.S.) and to examine associations between dietary and socioeconomic factors. Design: We examined baseline data from an evaluation study of a healthy food access initiative. Participants were recruited from two urban settings comprising seven neighborhoods of high household poverty (17% to 62%). Participants completed in-person interviews with measures of education, household income, and food security and one unannounced 24-hour dietary recall by telephone with trained registered dietitians. Food desert residence was coded based on U.S. Census data. Proportions meeting 2010 Dietary Guidelines for Americans and Healthy Eating Index 2010 (HEI-2010) scores were computed. Associations between dietary variables and participant’s education, household income, food security, and food desert residence were tested. Results: Participants (n = 465) were predominantly African American (92%), women (80%), and overweight or obese (79%), and 52 ± 14 years of age. Sixty-three percent had low or very low food security, and 82% lived in census tracts of low income and low access to supermarkets (urban food desert). HEI-2010 scores averaged 48.8 ± 13.1. A minority of participants met dietary guidelines. Diet quality was lower among participants with lower education and among those from food insecure households (p < .05). Household income and food security were positively associated with meeting several dietary guidelines (p < .05). Food desert residence was unrelated to diet variables. Conclusions: In this disadvantaged population, significant nutritional concerns were observed, and socioeconomic factors were associated with diet quality and meeting dietary guidelines. Interventions must address broader economic, social, and policy issues such as access to affordable healthy foods.

Offsetting the Effects of Neighborhood Disadvantage on Problem Drinking.

Residence in disadvantaged neighborhoods can amplify individual risk for adverse health conditions, including substance use disorders. Using data from a probability sample of problem drinkers in Northern California (N=616) interviewed at baseline and re-interviewed one year later, this study examines whether social support can buffer negative effects of neighborhood disadvantage on problem drinking. Living in a disadvantaged neighborhood increased the likelihood of problem drinking at follow-up (OR=2.33, p=0.015). Although baseline support for reducing drinking was unrelated to problem drinking at follow-up, there was a significant interaction between neighborhood disadvantage and support. Among those living in disadvantaged neighborhoods, baseline support significantly decreased the likelihood of problem drinking at follow-up (OR=0.19, p=0.048). Bolstering indigenous community resources where residents can interact with others in recovery or that foster sober activities may offset individual risk. Research is needed to determine whether this may also produce second-order neighborhood change.

Neighborhood Differences in Post-Stroke Mortality.

Post-stroke mortality is higher among residents of disadvantaged neighborhoods, but it is not known whether neighborhood inequalities are specific to stroke survival or similar to mortality patterns in the general population. We hypothesized that neighborhood disadvantage would predict higher poststroke mortality, and neighborhood effects would be relatively larger for stroke patients than for individuals with no history of stroke. Health and Retirement Study participants aged ≥50 years without stroke at baseline (n=15 560) were followed ≤12 years for incident stroke (1715 events over 159 286 person-years) and mortality (5325 deaths). Baseline neighborhood characteristics included objective measures based on census tracts (family income, poverty, deprivation, residential stability, and percent white, black, or foreign-born) and self-reported neighborhood social ties. Using Cox proportional hazard models, we compared neighborhood mortality effects for people with versus people without a history of stroke. Most neighborhood variables predicted mortality for both stroke patients and the general population in demographic-adjusted models. Neighborhood percent white predicted lower mortality for stroke survivors (hazard ratio, 0.75 for neighborhoods in highest 25th percentile versus below, 95% confidence interval, 0.62-0.91) more strongly than for stroke-free adults (hazard ratio, 0.92; 95% confidence interval, 0.83-1.02; P=0.04 for stroke-by-neighborhood interaction). No other neighborhood characteristic had different effects for people with versus without stroke. Neighborhood-mortality associations emerged within 3 months after stroke, when associations were often stronger than among stroke-free individuals. Neighborhood characteristics predict mortality, but most effects are similar for individuals without stroke. Eliminating disparities in stroke survival may require addressing pathways that are not specific to traditional poststroke care.

Interactions between Neighbourhood Urban Form and Socioeconomic Status and Their Associations with Anthropometric Measurements in Canadian Adults.

Neighbourhood-level socioeconomic composition and built context are correlates of weight-related behaviours. We investigated the relations between objective measures of neighbourhood design and socioeconomic status (SES) and their interaction, in relation to self-reported waist circumference (WC), waist-to-hip ratio, and body mass index (BMI) in a sample of Canadian adults (n = 851 from 12 Calgary neighbourhoods). WC and BMI were higher among residents of disadvantaged neighbourhoods, independent of neighbourhood design (grid, warped grid, and curvilinear street patterns) and individual-level characteristics (sex, age, education, income, dog ownership, marital status, number of dependents, motor vehicle access, smoking, sleep, mental health, physical health, and past attempts to modify bodyweight). The association between neighbourhood-level SES and WC was modified by neighbourhood design; WC was higher in disadvantaged-curvilinear neighbourhoods and lower in advantaged-grid neighbourhoods. Policies making less obesogenic neighbourhoods affordable to low socioeconomic households and that improve the supportiveness for behaviours leading to healthy weight in low socioeconomic neighbourhoods are necessary.

“It's Not Just a Bunch of Buildings”: Social Psychological Investment, Sense of Community, and Collective Efficacy in a Multiethnic Low–Income Neighborhood

This analysis of social life in a poor, multiethnic public housing neighborhood presents an opportunity for refinement of social disorganization theory. Drawing on data from interviews, focus groups, and participant observations among residents, I find that this neighborhood exhibits substantial collective efficacy, despite social disorganization theory's predictions that the structural conditions of high poverty and racial and ethnic diversity result in low collective efficacy. I explicate two social psychological investment strategies—sense of ownership and symbolic representation—that appear to facilitate a sense of community and ultimately collective efficacy, helping to explain this apparent anomaly. I argue that even in the presence of structural disadvantage, having a strong sense of community provides a basis for beneficial action on behalf of the collective because it constitutes a source of shared expectations about values and norms in the neighborhood. These findings suggest refinements to the social disorganization framework, but also provide foundational ideas for policy interventions that may improve the social lives of residents in disadvantaged neighborhoods.

Neighbourhood disadvantage and self-reported type 2 diabetes, heart disease and comorbidity: a cross-sectional multilevel study

PurposeThis study examines associations between neighborhood socioeconomic disadvantage and self-reported type 2 diabetes and heart disease, occurring separately and concurrently at a single time point (comorbidity). MethodsThis study included 11,035 residents from 200 neighborhoods in Brisbane, Australia. Respondents self-reported type 2 diabetes and heart disease as long-term health conditions. Neighborhood socioeconomic disadvantage was measured using a census-derived composite index. Individual socioeconomic position was measured using education, occupation, and household income. Data were analyzed using multilevel multinomial mixed-effects logistic regression using Markov chain Monte Carlo simulation. ResultsCompared with the most advantaged neighborhoods, residents of the most-disadvantaged neighborhoods were more likely to report type 2 diabetes (odds ratio [OR] = 2.21, 95% credible interval [CrI] = 1.55–3.15), heart disease (OR = 1.72, 95% CrI = 1.25–2.38), and comorbidity (OR = 4.38, 95% CrI = 2.27–8.66). This relationship attenuated after adjustment for individual-level socioeconomic position, but remained statistically significant for type 2 diabetes (OR = 1.81, 95% CrI = 1.15–2.83) and comorbidity (OR = 3.00, 95% CrI = 1.49–6.13). ConclusionsStudies of neighborhood disadvantage that fail to include individual-level socioeconomic measures may inflate associations. Establishing why residents of disadvantaged neighborhoods are more likely to experience the co-occurrence of heart disease and type 2 diabetes independent of their individual socioeconomic position warrants further investigation.

Social cohesion, neighbourhood resilience, and health: evidence from New Deal for Communities programme

BackgroundThe contribution of socioeconomic determinants to health is well established, whereas the role of contextual and environmental factors, such as social community cohesion and control, remains understudied. These factors could possibly be the drivers of neighbourhood resilience, and hence help to explain variation in health among residents of communities situated in similarly disadvantaged neighbourhoods. This study aimed to assess the effects of different dimensions of social cohesion on resilience and health in disadvantaged neighbourhoods in the UK. MethodsTo explore which elements of social cohesion are associated with self-assessed health and mental health of residents living in communities in disadvantaged neighbourhoods, we conducted secondary data analysis using four waves (2002–08) of biannual repeat cross-sectional surveys collected for the New Deal for Communities programme (about 17 710 individuals per wave). Ten items depicting community social cohesion were subjected to principal axis factor analysis with varimax rotation. Two-level logit models accounted for the clustering of residents (level 1) within 39 areas (level 2), and were used to estimate the likelihood of reporting good self-assessed health and good mental health. To check robustness, analyses were repeated on pooled data after excluding duplications. FindingsThree social cohesion factors explained 54·4% of the total variance (Kaiser-Meyer-Olkin 0·784; χ2=36890·26, df=45, p<0·0001) and were classified as trust in local organisations, social network and neighbourliness, and control and participation. After adjustment for baseline and sociodemographic characteristics, two social cohesion factors (trust in local organisations, and social network and neighbourliness) were associated with good self-assessed health (odds ratio 1·29 [95% CI 1·22–1·35] and 1·09 [1·04–1·15], respectively). Associations with control and participation were not significant. Findings for mental health showed a similar pattern. InterpretationOur preliminary results illustrate the importance of social cohesion, particularly of trust in local organisations and social network and neighbourliness for self-assessed and mental health among residents of disadvantaged neighbourhoods. These findings support recent public health strategies that emphasise the importance of community cohesion and control to promote neighbourhood resilience and initiatives aimed at reduction of health and social inequalities. FundingThis work was supported by the National Institute for Health Research (NIHR) School for Public Health Research.