TM2-O-08 Introduction: Concern about the impact of the environment on health and well-being has tended to focus on the physical effects of exposure to toxic and infectious substances. The focus has been on large-scale infrastructure rather than on more subjective perceptions of street-level aspects of neighborhoods such as litter and graffiti, which are increasingly regarded as components of environmental justice. It has been suggested that more attention should be focused on psychosocial impacts (eg, feelings about the quality of the local environment) upon health and well-being. However, little is known about the relative importance upon health of perceptions of different components of environmental justice. Methods: A random sample of 1637 adults across a range of neighborhoods in Scotland were interviewed as part of the 2004 Scottish Social Attitudes survey. Respondents were asked to rate their local area on the amount of, and perceived problem with (both currently or potentially present), a range of aspects of their local neighborhood. These were subsequently grouped into 3 domains: 1) “street level incivilities” (eg, litter, graffiti), 2) large-scale infrastructure (eg, phone masts), and 3) the absence of “environmental goods” (eg, safe play areas for children). In addition to collecting information on respondents' socio-demographic characteristics, we also gathered data on respondents' views of their own health and well-being and health behaviors (smoking and physical activity). For each of the 3 domains of perceived local environment, we examined their prevalence, and extent to which they presented a problem, according to respondents' individual characteristics or the characteristics of the area in which they live; we then explored relationships between reported experience of each of the 3 domains and self-assessed health and behavior (using logistic regression). Results: Higher levels of perceived “street-level incivilities” and absence of “environmental goods” were associated with increased anxiety and depression and an increased likelihood of smoking, even after taking other known correlates into account (such as gender, age, and social class). Few associations with health were observed for perceptions of the larger-scale infrastructural items. Conclusions: Environmental policy needs to give more priority to reducing the incidence of “street-level incivilities” and the absence of “environmental goods,” both of which appear to be more important for health than perceptions of larger scale infrastructural items. We propose the construction of a new index of environmental quality, which could be used to monitor the quality of local neighborhoods and inform policy aimed at reducing health inequalities.