Neighborhood Social Characteristics Research Articles

Health equity in urban and rural settings: implementation of the place standard tool in Spain

The physical, social, and economic characteristics of neighborhoods and municipalities determine the health of their residents, shaping their behaviors and choices regarding health and well-being. Addressing local environmental inequalities requires an intersectoral, participatory, and equity-focused approach. Community participation plays a vital role by providing deeper insights into local contexts, integrating community knowledge and values into processes, and promoting healthier, fairer, and more equitable actions. In recent years, various tools have been developed to assess places and transform them into health-promoting settings. One such tool, the Place Standard Tool (PST), facilitates discussions on Social Determinants of Health grouped into 14 themes, serving as a starting point for local health interventions. In this study, that took place between August 2019 and February 2020, we described the resident’s perceptions of two municipalities in the Valencian Community, Spain, using the validated Spanish version of the PST. A mixed-method convergent-parallel design was used to gain a holistic insight into residents’ experiences concerning their physical, economic, and social environment. A total of 356 individuals from both municipalities participated in the study through discussion groups, structured interviews, and online survey. Descriptive analysis of the individual questionnaire answers was conducted, and differences between municipalities were explored. Qualitative thematic analysis was conducted on structured interviews and discussion groups. Quantitative and qualitative data were integrated to facilitate their comparison and identify areas of convergence or divergence in the findings. Overall, rural areas received more favorable evaluations compared to urban ones. Public Transport as well as Work and Local Economy were consistently rated the lowest across all groups and contexts, while Identity and Belonging received the highest ratings. In the urban area, additional negative ratings were observed for Traffic and Parking, Housing and Community, and Care and Maintenance. Conversely, Identity and Belonging, Natural Spaces, Streets and Spaces, Social Interaction, and Services emerged as the highest-rated themes overall. In the rural context, positive evaluations were given to Walking or Cycling, Traffic and Parking, Housing and Community, and Influence and Sense of Control. Significant differences (p < 0.01) between urban and rural settings were observed in dimensions related to mobility, spaces, housing, social interaction, and identity and belonging. Our study illustrated the capacity of the PST to identifying aspects within local settings that influence health, revealing both positive and challenging factors. Successful implementation requires appropriate territorial delineation, support from local authorities, and effective management of expectations. Furthermore, the tool facilitated community participation in decision-making about local environments, promoting equity by connecting institutional processes with citizen needs.

Neighborhood features moderate genetic and environmental influences on children's social information processing.

Neighborhood is a key context where children learn to process social information; however, the field has largely overlooked the ways children's individual characteristics might be moderated by neighborhood effects. We examined 1,030 six- to 11-year-olds (48.7% female; 82% White) twin pairs oversampled for neighborhood disadvantage from the Twin Study of Behavioral and Emotional Development in Children. We evaluated neighbor reports (N = 1,880) of neighborhood structural and social characteristics as moderators of genetic and environmental influences on children's social processing. Although there was no evidence of moderation for children's hostile attributions, there was robust evidence that the social and structural characteristics of the neighborhood moderated the genetic and environmental origins of children's positive expectations of aggressive behavior. Specifically, we found that genetic influences on aggressive expectations increased in the presence of neighborhood deprivation and decreased in the presence of protective social processes and availability of resources. Such findings suggest that protective neighborhood social processes may buffer against the development of aggressive expectations during middle childhood by suppressing the expression of genetic influences on those outcomes. In doing so, they suggest that neighborhood social processes may be able to promote youth resilience to neighborhood deprivation "under the skin." (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Caring neighbourhood and loneliness: Importance of applying a place-based perspective.

Background: Loneliness is recognized as an important societal challenge, with high policy attention the last years. In Flanders an important policy objective is to counteract loneliness by investing in so-called caring neighbourhoods. Although some research indicates that physical and social neighbourhood characteristics (e.g. public parks, public transportation) affect loneliness, little is known in this respect. 
 Aim: The goal of this workshop is to gain more insight into the relation between the neighbourhood and loneliness. Further, much loneliness research is limited to specific age groups and does not take into account the different dimensions of loneliness (emotional, social and existential). This distinction is nevertheless crucial because interventions that aim to counteract loneliness must be tailored around the unique needs of the individual and must consider specific dimensions of loneliness. 
 Participants: The workshop is for everyone interested in how neighbourhood characteristics impact loneliness among people of all ages, and on how to deal with this in research and practice. Both people with and without experience in the subject are welcome.
 Design of the workshop:
 1.Inspirational presentations (40’)
 •Insight into loneliness prevalence. Hannelore Stegen conducted a systematic literature review and meta-analysis on the prevalence of loneliness among community-dwelling older people. We will discuss how different measurement instruments and modes of datacollection lead to different results.
 •Presentation of the FWO-SBO project ‘A Lonely Planet?’. In this part, we discuss which neighbourhood characteristics relate to the risk of loneliness. Leen Heylen, Liesbeth De Donder and Jasper De Witte present the first results of the interuniversity research project A Lonely Planet? Addressing LONELIness from a PLAce-based perspective: research on the influence of Neighbourhood and Environment. Goal is to increase our understanding on the role of neighbourhood characteristics in loneliness.
 •Third, SAAMO Limburg & West-Vlaanderen (i.e. Community Building Organisation) add a practitioner perspective. Together we dive into possibilities on how to deal with tackling and preventing loneliness in caring neighbourhoods. Which neighbourhood level practices can prevent or alleviate loneliness? They present their experiences with several practical projects. 
 •After each presentation, space is reserved for questions and reflections of the audience. 
 2.Interactive work-tables. Through interactive “work-tables” with the participants, we aim to formulate specific recommendations on how to prevent and counteract loneliness from a neighbourhood perspective. (35’)
 Table 1: Which neighbourhood characteristics relate to the risk of loneliness among adults?
 Table 2: How do neighbourhood characteristics relate to the risk of loneliness among adults?
 Table 3: In which manner can loneliness be prevented and alleviated on a neighbourhood level?
 3.Closing: plenary ‘sharing’ session (15’)
 A participant of each table shares the main take-away-home messages from their table. 
 End goal: The goal of this workshop is to create awareness among the participants about the impact that neighbourhood characteristics can have on the level of loneliness among people of all ages, as well as on how to deal with it in practice, research and policy. The co-created content of the workshop will be gathered in a report and shared on the website of “A Lonely Planet”.

Police Violence as Containment of Black Bodies during Urban Renewal: A Spatial Analysis of Civilian Deaths by Police in Florida

abstract: This study presents a geospatial analysis of police killings within two areas in Florida over a twenty-year period. Fatalities were mapped against social and economic characteristics of neighborhoods to ascertain if police violence ending in civilian death was concentrated in areas with high-minority and low-income populations, and those areas in proximity to gentrifying neighborhoods. We evaluated the theory that police violence against minority residents serves as a process of containment and ultimately supports the continued generation of wealth by a specific sector of society through the process of gentrification. The cycle of destruction and renewal in the urban landscape is deeply intertwined with processes of capital accumulation, class differentiation, and racial subordination. Both the West Florida and Southeast Florida areas contained a significantly higher proportion of fatal encounters occurring within tracts that were eligible to gentrify than in tracts that were in the process of gentrifying. Fort Lauderdale in particular had little overlap despite containing concentrated hotspots of incidents in combination with high-minority and low–NSES tracts. This same pattern is apparent in the Lakeland area in west Florida. Our findings are consistent with Laniyonu's observation that police interactions tend to increase in tracts just outside of gentrified areas, but seldom within them.

Time trends in associations between neighbourhood and school characteristics and mental health problems among Dutch adolescents

We investigated trends in associations between physical and social neighbourhood and school characteristics and adolescent mental health problems between 2005 and 2017. Nationally representative, repeated cross-sectional data collected in the Netherlands among primary (N = 5,871) and secondary school students (N = 20,778) were analysed through cross-classified multilevel models. Hardly any evidence was found for over-time changes in associations between neighbourhood and school characteristics and adolescent mental health problems. Findings showed that for both groups of students, only social characteristics within the two contexts were associated with adolescent mental health problems. For secondary school students, school effects were larger than neighbourhood effects, while the opposite was true for primary school students. Specifically, primary school students residing in more socially fragmented or lower socioeconomic status (SES) neighbourhoods, and lower SES schools, reported more conduct problems and peer relationship problems. For secondary school students, only the SES of the neighbourhood and the school was associated with all four aspects of mental health problems. Remarkably, the direction of the associations between neighbourhood/ school SES and adolescent mental health problems varied across the different mental health outcomes. More research is warranted to replicate our findings.

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.

Social and built neighborhood environments and sleep health: The Hispanic Community Health Study/Study of Latinos Community and Surrounding Areas and Sueño Ancillary Studies.

To test associations between neighborhood social, built, and ambient environment characteristics and multidimensional sleep health in Hispanic/Latino adults. Data were from San Diego-based Hispanic/Latino adults mostly of Mexican heritage enrolled in the Hispanic Community Health Study/Study of Latinos (N = 342). Home addresses were geocoded to ascertain neighborhood characteristics of greenness, walkability (density of intersections, retail spaces, and residences), socioeconomic deprivation (e.g. lower income, lower education), social disorder (e.g. vacant buildings, crime), traffic density, and air pollution (PM 2.5) in the Study of Latinos Communities and Surrounding Areas Study. Sleep dimensions of regularity, satisfaction, alertness, timing, efficiency, and duration were measured by self-report or actigraphy approximately 2 years later. Multivariable regression models accounting for study design (stratification and clustering) were used to examine associations of neighborhood variables with individual sleep dimensions and a multidimensional sleep health composite score. Neighborhood characteristics were not significantly associated with the multidimensional sleep health composite, and there were few significant associations with individual sleep dimensions. Greater levels of air pollution (B = 9.03, 95% CI: 1.16, 16.91) were associated with later sleep midpoint, while greater social disorder (B = -6.90, 95% CI: -13.12, -0.67) was associated with earlier sleep midpoint. Lower walkability was associated with more wake after sleep onset (B = -3.58, 95% CI: -7.07, -0.09). Living in neighborhoods with lower walkability and greater air pollution was associated with worse sleep health, but otherwise findings were largely null. Future research should test these hypotheses in settings with greater variability and investigate mechanisms of these associations.

Perceived Neighborhood Characteristics and Sleep in Australian Adults.

Poor sleep can contribute to poorer health and socioemotional outcomes. Sleep health can be influenced by a range of individual and other socioecological factors. Perceptions of neighborhood physical and social characteristics reflect broader social-level factors that may influence sleep, which have not been well studied in the Australian context. This study examined the association between perceived neighborhood characteristics and sleep in a large sample of Australians. Data were from 9,792 people aged 16 years or older, from Waves 16 and 17 of the nationally representative Household, Income and Labour Dynamics in Australia Survey. Associations between perceived neighborhood characteristics (neighborly interaction and support, environmental noise, physical condition, and insecurity) and self-reported sleep duration, sleep disturbance, and napping were examined using multiple logistic regression models. "Neighborhood interaction and support" and "neighborhood physical condition" were not significantly associated with any sleep outcomes after adjusting for relevant covariates. However, "environmental noise" and "neighborhood insecurity" remained significantly associated with sleep duration and sleep disturbance. None of the neighborhood characteristics were associated with napping. Furthermore, associations did not significantly vary by gender. This study highlights the potential benefit of public health policies to address noise and safety in neighborhoods to improve sleep.

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

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

Perceived environment and neighbourhood satisfaction: introducing a fuzzy modeling approach

ABSTRACT The present study aims at developing the existing methodology to determine the predictors of neighborhood satisfaction under an uncertain environment. To achieve this purpose, required data are gathered from 320 households living in Shiraz, Iran, including their perceptions of neighborhood social characteristics and neighborhood satisfaction through a questionnaire survey. Due to uncertainty among the numeric independent variables, a set of fuzzy estimation systems are developed, each of which predicts the value of neighborhood satisfaction using the values of one specific subset of the influencing independent variables. According to the findings, the environmental characteristics of neighborhood contribute to improving neighborhood satisfaction more effectively than individual attributes of residents. Fuzzy results, also, show that perceived security, social control and trust are important predictors of neighborhood satisfaction among single variables, while the combination of trust and perceived security has the strongest effect among all variables and can determine neighborhood satisfaction with a high accuracy. Parts of the results were consistent with prior research. There are important implications for researchers and policy-makers in the findings.

Social and physical neighbourhood characteristics and 10-year incidence of depression and anxiety in older adults: Results from the Longitudinal Aging Study Amsterdam

ObjectiveA growing literature suggests that neighbourhood characteristics are associated with mental health outcomes, but the evidence in older adults is inconsistent. We investigated the association of neighbourhood characteristics, pertaining to demographic, socio-economic, social and physical environment domains, with the subsequent 10-year incidence of depression and anxiety, in Dutch older adults. MethodsIn the Longitudinal Aging Study Amsterdam depressive and anxiety symptoms were assessed four times between 2005/2006 and 2015/2016, using the Center for Epidemiological Studies Depression Scale (n = 1365) and the Anxiety subscale of the Hospital Anxiety and Depression Scale (n = 1420). Neighbourhood-level data on urban density, percent population over 65 years of age, percent immigrants, average house price, average income, percent low-income earners, social security beneficiaries, social cohesion, safety, proximity to retail facilities, housing quality, percent green space, percent water coverage, air pollution (particulate matter (PM2.5)), and traffic noise, were obtained for study baseline years 2005/2006. Cox proportional hazard regression models, clustered within neighbourhood, were used to estimate the association between each neighbourhood-level characteristic and the incidence of depression and anxiety. ResultsThe incidence of depression and anxiety was 19.9 and 13.2 per 1000 person-years, respectively. Neighbourhood characteristics were not associated with the incidence of depression. However, various neighbourhood characteristics were associated with an increased incidence of anxiety, including: higher urban density level, higher percent immigrants, greater proximity to retail facilities, lower housing quality score, lower safety score, higher PM2.5 levels and less green space. ConclusionOur results indicate that several neighbourhood characteristics are associated with anxiety but not with depression incidence in older age. Several of these characteristics have the potential to be modifiable and thus could serve as a target for interventions at the neighbourhood-level in improving anxiety, provided that future studies replicate our findings and provide further evidence for a causal effect.

Examining Place-Based Neighborhood Factors in a Multisite Peer-Led Healthy Lifestyle Effectiveness Trial for People with Serious Mental Illness.

People with severe mental illness (SMI) experience significantly higher obesity-related comorbidities and premature mortality rates than healthy populations. The physical and social characteristics of neighborhoods where people with SMI reside can play an important role in promoting or hindering healthy eating and physical activity. However, this is seldom considered when designing and testing health behavior interventions for these populations. This study used baseline data from an obesity control trial for low-income, minority people with SMI to demonstrate the utility of assessing neighborhood- and city-level place-based factors within the context of lifestyle interventions. GIS was used to create a zip-code-level social and built environment geodatabase in New York City and Philadelphia, where the trial occurred. Chi-square and t-tests were used to assess differences in the spatial distribution of health-related built and social environment characteristics between and within cities and diet and physical activity outcomes. All types of neighborhood characteristics showed significant environmental differences between and within cities. Several neighborhood characteristics were associated with participants' baseline healthy eating and physical activity behaviors, emphasizing that place-based factors may moderate lifestyle interventions for SMI patients. Future behavioral interventions targeting place-dependent behaviors should be powered and designed to assess potential moderation by place-based factors.

Examining Train Stations as Crime Generators and the Protective Effect of “Regular” Riders

Understanding whose eyes make up the ambient population is an important development of crime opportunities research. We hypothesize that regularity at train stations will influence place-awareness and therefore the balance between potential crime offenders, targets, and victims in the ambient population. Drawing on one year of travel card and police-recorded crime data we examine the association between percentage of regular passengers and crime at 134 train stations, controlling for land use and neighborhood social demographic characteristics. We find regularity has a buffering impact on theft and property damage at stations but this effect is curvilinear in the case of theft. Regularity was not associated with assault or motor vehicle crime, we discuss implications for theory and practice.

Categorizing relative water use perception bias using household surveys and monthly water bills

We introduce the concept of relative water use perception bias to highlight the role of human relationships, social cues, and the built environment in household water consumption. Although previous studies have explored actual water use, it is also important to understand how people perceive their relative behaviors because humans are social animals and act in relation to each other. We combine household survey responses and water utility bills in a large sample of households to quantify the degree of over- and under-estimation bias in perceived relative household water use. We then use multi-level nested regression models to investigate four categories of potential influence: sociodemographic characteristics, perceived social norms, neighborhood characteristics, and water bill information. Results show that most households tended to view themselves as ‘better than average’ water users when they actually used more water compared to neighbors. Respondents in high-income households and those who are more concerned about water shortages were more likely to underestimate their relative water use (using comparatively more than they thought). However, in more suburbanized neighborhood environments, households were more likely to overestimate their relative water use (using comparatively less than they thought). We call the inaccuracy in assessing water usage compared to their neighbors' relative water use perception bias. We propose that a better understanding of this bias can aid the design of policy initiatives like neighborhood planning, better water bill design, targeted messaging, and social signaling. By bringing a relational lens to bear on water conservation studies, understanding relative water use perception bias sheds new light on the complex drivers of household water consumption.

Neighborhood Socioeconomic Status and Women's Mental Health: A Longitudinal Study of Hurricane Katrina Survivors, 2005-2015.

There is limited knowledge on the relationship between neighborhood factors and mental health among displaced disaster survivors, particularly among women. Hurricane Katrina (Katrina) was the largest internal displacement in the United States (U.S.), which presented itself as a natural experiment. We examined the association between neighborhood socioeconomic status (SES) and mental health among women up to 10 years following Katrina (N = 394). We also investigated whether this association was modified by move status, comparing women who were permanently displaced to those who had returned to their pre-Katrina residence. We used hierarchical linear models to measure this association, using data from the American Community Survey and the Gulf Coast Child and Family Health study. Neighborhood SES was created as an index which represented social and economic characteristics of participants' neighborhoods. Mental health was measured using mental component summary (MCS) scores. Increased neighborhood SES was positively associated with mental health after controlling for age, race/ethnicity, economic positioning, time, and move status (19.6, 95% Confidence Interval: 5.8, 33.7). Neighborhood SES and mental health was also modified by move status. These findings underscore the need to better understand the impacts of socioeconomic conditions and health outcomes among women affected by natural disasters.

Anger expression moderates the effects of neighborhood disadvantage on cognitive decline among African‐Americans in the Jackson Heart Study and Atherosclerosis Risk in Communities study

AbstractBackgroundPrevious research has identified neighborhoods and individual psychosocial characteristics such as anger expression as important contributors to cognitive health. However, less is known about whether neighborhood environments interact with individual psychosocial characteristics to confer increased susceptibility to adverse cognitive outcomes such as accelerated cognitive decline. We tested the hypothesis that internalized anger will strengthen the associations between neighborhood disadvantage and faster rates of cognitive decline.MethodAmong 1,314 African Americans dually enrolled in two community‐based cohorts in Jackson, Mississippi—the ARIC and JHS cohort studies—a factor score of global cognitive function was calculated based on ten cognitive tests of working memory, language, and executive function administered repeatedly from 1996 to 2019. Age‐ and sex‐adjusted linear mixed effects models were used to examine whether individual‐level anger expression moderated the associations of four measures of census tract‐level neighborhood socioeconomic and social environment characteristics (the national Area Deprivation Index (ADI), a JHS neighborhood disadvantage score, racial residential segregation, and perceived physical disorder) with individual‐level cognitive decline.ResultOf the four neighborhood characteristics, greater JHS neighborhood disadvantage and racial residential segregation were associated with faster rates of 10‐year cognitive decline. Among those with high inward anger expression (&gt;1 SD above the mean), there was a 33% and 35% faster rate of decline in global cognition associated with higher neighborhood disadvantage (as measured by the JHS score) and segregation, respectively (Table).ConclusionDispositional inward anger expression may increase susceptibility to the detrimental impacts of neighborhood disadvantage on cognitive health.

Neighbourhood socio-economic status and positive affectivity among older residents in Germany: a cross-sectional analysis with data from the Heinz Nixdorf Recall Study

BackgroundPhysical and social neighbourhood characteristics can vary according to the neighbourhood socio-economic status (SES) and influence residents’ perceptions, behaviours and health outcomes both positively and negatively. Neighbourhood SES has been shown to be predictive of mental health, which is relevant for healthy ageing and prevention of dementia or depression. Positive affectivity (PA) is an established indicator of mental health and might indicate a positive emotional response to neighbourhood characteristics. In this study, we focussed on the association of neighbourhood SES with PA among older residents in Germany and considered social integration and environmental perceptions in this association.MethodsWe used questionnaire-based data of the ongoing population-based Heinz Nixdorf Recall Study for our cross-sectional analysis, complemented by secondary data on social welfare rates in the neighbourhood of residents’ address. PA was assessed using the Positive and Negative Affect Schedule (PANAS) in 2016. Linear regression models were performed to estimate the associations and adjusted for socio-demographic variables.ResultsHigher social welfare rates were associated with lower PA scores. The strongest negative association from the crude model (b = −1.916, 95%-CI [−2.997, −0.835]) was reduced after controlling for socio-demographic variables (b = −1.429, 95%-CI [−2.511, −0.346]). Social integration factors (b = −1.199, 95%-CI [−2.276, −0.121]) and perceived environmental factors (b = −0.875, 95%-CI [−1.971, 0.221]) additionally diminished the association of social welfare rates with PA in the full model (b = −0.945, 95%-CI [−2.037, 0.147]).ConclusionOur results suggest that neighbourhoods have an influence on the occurrence and the extent of PA. Public health interventions that address socio-economic disadvantage in the neighbourhood environment could be an effective and far-reaching way to reduce the risk of depression and depressive symptoms due to low PA in older residents.

Predictors of electronic health record (EHR) portal registration and frequency of portal use among patients with cancer prior to engagement in the IMPACT Consortium symptom management trials.

419 Background: The patient portal is part of an electronic health record (EHR) that allows patients to communicate with their healthcare team. The portal also provides a platform for patients to receive and complete symptom surveys that can be directly integrated into the EHR, allowing clinical care teams to monitor symptoms and provide cancer symptom management. The Improving Management of symPtoms during And following Cancer Treatment (IMPACT) consortium, supported by the National Cancer Institute’s Cancer MoonshotSM, aims to improve symptom control for cancer patients through assessment and symptom management interventions deployed via the EHR. This initiative presents an opportunity to examine portal enrollment and variation in use, factors critical to successful implementation, especially among groups that have high cancer symptom burden. To this end, we examine: 1) relationships between portal enrollment prior to the launch of IMPACT interventions and neighborhood broadband access, demographic, and social characteristics; and 2) frequency of pre-intervention portal use for any purpose among enrollees. Methods: Data are derived from two of three IMPACT research centers. Enrollment in and frequency of portal use, mode of accessing the portal (web vs. phone), social, demographic, and cultural factors were extracted from the EHR. Rural Urban Commuting Area (RUCA) codes were used to classify population density and degree of rurality. Broadband access was estimated using 2015-2019 American Community Survey estimates matched to zip codes from enrolled IMPACT patients and classified as a patient’s residence being in a community with high (≥85% of households) or low (&lt; 85% of households) access. Bivariate comparisons and adjusted odds ratios were used to describe all associations. Results: Forty-seven percent of patients (22,596/48,034) were enrolled in the portal prior to the intervention. Patients in zip codes with low broadband access and those who were men, &gt; 65 years old, not White, of Hispanic ethnicity, or disabled or not employed had significantly lower odds of being enrolled in the portal. If enrolled, 21% (n = 4825) used the portal at least once a week. Less variation was found in the average frequency of portal use, but patients younger than 40, and those who were Black, disabled, unemployed, or those who used a mobile device to access the portal had the lowest odds of accessing it at least once a week. Conclusions: Significant disparities in portal enrollment exist across demographic groups and among those with limited broadband access. Among those enrolled, most used the portal less than once a week. Fewer differences in frequency of use were observed by sociodemographic factors. Improving portal enrollment and frequency of use may be critical for symptom management interventions deployed via patient portals.

Neighbourhood correlates of average population walking: using aggregated, anonymised mobile phone data to identify where people walk.

Understanding and monitoring socio-spatial patterns of population walking mobility can inform urban planning and geographically targeted health promotion strategies aimed at increasing population levels of physical activity. In this study we use aggregated, anonymous mobile phone mobility data to examine the association between neighbourhood physical and social characteristics and residents' weekly walking behaviour across 313 neighbourhoods in a large metropolitan region of Queensland, Australia. We find that residents in neighbourhoods that are highly fragmented by streets with speed limits above 50 kmph, residents in neighbourhoods with high retail density and those living is economically disadvantaged neighbourhoods walk fewer kilometres and minutes on average per week than their counterparts. These findings can inform urban planning policy on the minimum specifications required in newly developing neighbourhoods and provide targets for retro-fitting features into existing neighbourhoods.

Neighborhood social context and suicide mortality: A multilevel register-based 5-year follow-up study of 2.7 million individuals

Previous studies have linked neighborhood social characteristics to suicide mortality. However, the effects of the operational definition of neighborhoods and the general importance of neighborhood context on suicide mortality have received little attention, with most studies using various administrative areas as neighborhood delineations. In this study, neighborhoods were delineated by micro-areas generated with an automated redistricting algorithm and divided by physical barriers, such as large roads. The geographic data were linked to register data on the Danish adult population in the age range of 20–59 years in December 2013 (N = 2,672,799 individuals nested into 7943 neighborhoods). This cohort was followed for five years to evaluate the association between suicide mortality and neighborhood socioeconomic deprivation, social fragmentation, and population density. We used the median hazard ratio (MHR) to quantify the general contextual effect (GCE) of neighborhoods on suicide mortality and hazard ratios to quantify the specific contextual effects (SCEs) using multilevel survival models stratified by age group. The results showed a larger GCE and larger SCEs of neighborhoods on suicide mortality for individuals aged 20–39 years compared with those aged 40–59 years. After controlling for individual characteristics, higher suicide mortality was observed for individuals living in the least densely populated neighborhoods and the most socially fragmented neighborhoods for both age groups. We found cross-level interactions between neighborhood population density and gender and ethnicity for those aged 40–59 years, as well as between neighborhood social fragmentation and ethnicity for those aged 20–39 years. The results indicate that beyond individual characteristics, the neighborhood social context may affect the risk of suicide, especially for people aged 20–39 years.