Where a person lives as a determinant of health.
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251 to 275 of 1,190Cities and Mental Health.
Background: More than half of the global population currently lives in cities, with an increasing trend for further urbanization. Living in cities is associated with increased population density, traffic noise and pollution, but also with better access to health care and other commodities.
Methods: This review is based on a selective literature search, providing an overview of the risk factors for mental illness in urban centers.
Results: Studies have shown that the risk for serious mental illness is generally higher in cities compared to rural areas. Epidemiological studies have associated growing up and living in cities with a considerably higher risk for schizophrenia. However, correlation is not causation and living in poverty can both contribute to and result from impairments associated with poor mental health. Social isolation and discrimination as well as poverty in the neighborho…
matched on Urban Population (mesh), neighborhood (text)
Resilience and mental health: how multisystemic processes contribute to positive outcomes.
More is known about the factors that predict mental disorder than about the factors and processes that promote positive development among individuals exposed to atypically high levels of stress or adversity. In this brief Review of the science of resilience, we show that the concept is best understood as the process of multiple biological, psychological, social, and ecological systems interacting in ways that help individuals to regain, sustain, or improve their mental wellbeing when challenged by one or more risk factors. Studies in fields as diverse as genetics, psychology, political science, architecture, and human ecology are showing that resilience depends just as much on the culturally relevant resources available to stressed individuals in their social, built, and natural environments as it does on individual thoughts, feelings, and behaviours. With growing interest in resilience …
matched on Built Environment (mesh)
Concept Mapping: Engaging Urban Men to Understand Community Influences on Partner Violence Perpetration.
Intimate partner violence (IPV) is a significant health concern rooted in community experiences and other social determinants. The purpose of this study is to understand community-based risk and protective factors of IPV perpetration through participatory research that engages men who use IPV. Secondarily, we assess the relative influence, as measured by ranking, of these factors regarding risk of IPV perpetration and stress. We conducted concept mapping with Baltimore men (n = 28), ages 18 and older, enrolled in an abuse intervention program (AIP), through partnership with a domestic violence agency. Concept mapping, a three-phase participatory process, generates ideas around an issue then visually presents impactful domains via multi-dimensional scaling and hierarchical clustering. Most participants were Black (87.5%) and 20-39 years old (75%). Seven key domains, or clusters, were esta…
matched on Residence Characteristics (mesh), Urban Population (mesh), Environment Design (mesh)
Neighbourhood-level age-friendliness in urban environments: associations with functional independence and physical activity in older adults after a fall.
Background: Population ageing and urbanisation are reshaping living environments and raising new challenges for promoting health and independence in later life. Age-friendly city initiatives aim to support active ageing, yet the relationship between environmental conditions, housing factors, and functional outcomes remains insufficiently understood.
Methods: This cross-sectional study analysed data from participants of the SeFallED study in Oldenburg, Germany, which enrolled community-dwelling older adults (≥60 years) presenting to the emergency department due to a fall. Physical activity was assessed using accelerometry and self-report, life-space mobility using the Life-Space Assessment, and independence using instrumental activities of daily living (iADL). Neighbourhood-level age-friendliness was quantified using the Age-Friendly Cities and Communities Questionnaire (AFCCQ). Multiple …
matched on Residence Characteristics (mesh), Urban Population (mesh), neighbourhood (text)
Examining the association between rurality and positive childhood experiences among a national sample.
Purpose: The present study examines the association between rurality and positive childhood experiences (PCEs) among children and adolescents across all 50 states and the District of Columbia. Recent work has quantified the prevalence of PCEs at the national level, but these studies have been based on public use data files, which lack rurality information for 19 states.
Methods: Data for this cross-sectional analysis were drawn from 2016 to 2018 National Survey of Children's Health (NSCH), using the full data set with restricted geographic data (n = 63,000). Descriptive statistics and bivariate analyses were used to calculate proportions and unadjusted associations. Multivariable regression models were used to examine the association between residence and the PCEs that were significant in the bivariate analyses.
Findings: Rural children were more likely than urban children to be reported…
matched on Residence Characteristics (mesh), Rural Population (mesh), neighborhood (text)
Income and neighbourhood deprivation in relation to obesity in urban dwelling children 0-12 years of age: a cross-sectional study from 2013 to 2019.
Background: Childhood obesity is a major public health concern. This study evaluated the independent and joint associations of family-level income, neighbourhood-level income and neighbourhood deprivation, in relation to child obesity.
Methods: A cross-sectional study was conducted in children ≤12 years of age from TARGet Kids! primary care network (Greater Toronto Area, 2013-2019). Parent-reported family income was compared with median neighbourhood income and neighbourhood deprivation measured using the Ontario Marginalization Index. Children's height and weight were measured and body mass index (BMI) z-scores (zBMI) were calculated. ORs and 95% CIs were estimated for the three exposure variables separately using multilevel multinomial logistic regression models with zBMI categories as the outcome, adjusting in model 1 for age, sex, ethnicity and number of family members and in model 2…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighbourhood (text)
Quantification of Neighborhood-Level Social Determinants of Health in the Continental United States.
Importance: An association between social and neighborhood characteristics and health outcomes has been reported but remains poorly understood owing to complex multidimensional factors that vary across geographic space.
Objectives: To quantify social determinants of health (SDOH) as multiple dimensions across the continental United States (the 48 contiguous states and the District of Columbia) at a small-area resolution and to examine the association of SDOH with premature mortality within Chicago, Illinois.
Design, setting, and participants: In this cross-sectional study, census tracts from the US Census Bureau from 2014 were used to develop multidimensional SDOH indices and a regional typology of the continental United States at a small-area level (n = 71 901 census tracts with approximately 312 million persons) using dimension reduction and clustering machine learning techniques (unsu…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Leddy AM, Lippman SA, Neilands TB, Twine R, Ahern J, Gómez-Olivé FX, DeLong SM, MacPhail C, Kahn K, Pettifor AE (2019)MEDLINE-indexed journal, not yet read by usJournal of epidemiology and community health10 citations Community collective efficacy is associated with reduced physical intimate partner violence (IPV) incidence in the rural province of Mpumalanga, South Africa: findings from HPTN 068.
Background: Intimate partner violence (IPV) is a human rights violation and is associated with a variety of adverse physical and mental health outcomes. Collective efficacy, defined as mutual trust among community members and willingness to intervene on the behalf of the common good, has been associated with reduced neighbourhood violence. Limited research has explored whether community collective efficacy is associated with reduced incidence of IPV. This is of particular interest among adolescent girls and young women (AGYW) in sub-Saharan Africa, where the burden of HIV is greatest and IPV is common.
Methods: We collected longitudinal data among 2533 AGYW (ages 13-20) enrolled in the HPTN 068 cohort in Mpumalanga province, South Africa between 2011 and 2016. We included participants from 26 villages where community surveys were collected during the HPTN 068 study. Collective efficacy w…
matched on Residence Characteristics (mesh), Rural Population (mesh), neighbourhood (text)
The role of neighbourhood greenspace in children's spatial working memory.
Background: Exposure to nature may be particularly beneficial for the brain regions that support spatial working memory, a strong correlate of academic achievement.
Aims: To explore whether children living in greener neighbourhoods (wards) have better spatial working memory.
Sample: Drawn from the UK's Millennium Cohort Study, the sample was 4,758 11-year-olds living in urban areas in England.
Methods: We fitted two-level regression models, with children nested in wards, before and after adjustment for confounders, including poverty, parental education, sports participation, neighbourhood deprivation, and neighbourhood history. Spatial working memory was measured using the Cambridge Neuropsychological Test Automated Battery Spatial Working Memory task. Greenspace was measured as the percentage of greenery in the child's ward.
Results: Even after controlling for confounders, lower quantit…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighbourhood (text)
Self-rated health and its association with perceived environmental hazards, the social environment, and cultural stressors in an environmental justice population.
Background: Communities with large minority populations often are located near sources of pollution and have higher crime rates, which may work in combination with other factors to influence health. Poor self-rated health is related to chronic health conditions and premature mortality, with minority populations most likely to report poor health. To address how both resident perception of neighborhood environments and chronic health conditions individually and collectively influence health, we examined self-rated health and its association with multiple types of perceived environmental hazards in a majority-Hispanic urban population.
Methods: We conducted interviews with 354 residents of Chelsea, Massachusetts, US and asked about self-rated health, perceptions of their neighborhood, including participant-reported environmental hazards (e.g., air quality, odors and noise), aspects of the s…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Intergenerational Continuity in Adverse Childhood Experiences and Rural Community Environments.
Objectives: To understand the role of the community environment on intergenerational continuity in adverse childhood experiences (ACEs) among a rural White sample.
Methods: Parents in 12 counties in rural Iowa reported retrospectively on their own ACEs in 1989. We measured their child's ACEs retrospectively and prospectively across adolescence (n = 451 families). We measured structural and social process-related measures of community environment (i.e., community socioeconomic status, parents' perception of community services, perceived community social cohesion, and neighborhood alcohol vendor density) on multiple occasions during the child's adolescence.
Results: The 4 measures of community environment were all correlated with the child's ACEs, but only alcohol vendor density predicted ACEs after inclusion of covariates. Intergenerational continuity in ACEs was moderated by both social …
matched on Residence Characteristics (mesh), Rural Population (mesh), neighborhood (text)
Social isolation and loneliness in later life: A parallel convergent mixed-methods case study of older adults and their residential contexts in the Minneapolis metropolitan area, USA.
Social isolation and loneliness are increasingly prevalent among older adults in the United States, with implications for morbidity and mortality risk. Little research to date has examined the complex person-place transactions that contribute to social well-being in later life. This study aimed to characterize personal and neighborhood contextual influences on social isolation and loneliness among older adults. Interviews were conducted with independent-dwelling men and women (n = 124; mean age 71 years) in the Minneapolis metropolitan area (USA) from June to October, 2015. A convergent mixed-methods design was applied, whereby quantitative and qualitative approaches were used in parallel to gain simultaneous insights into statistical associations and in-depth individual perspectives. Logistic regression models predicted self-reported social isolation and loneliness, adjusted for age, ge…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Disentangling the mental health impact of childhood abuse and neglect.
It is unclear whether maltreatment types exert common or specific effects on mental health. In the current study, we aimed to systematically characterize the unique, shared and cumulative effects of maltreatment types on psychiatric symptoms, using data drawn from a community sample of high-risk youth (n=204, M=18.85). Analyses controlled for a range of potentially confounding variables, including socio-demographic variables, neighbourhood deprivation and levels of community violence exposure. Outcome measures included multi-informant reports of internalizing difficulties, as well as data on externalizing problems and trauma-related symptoms. We found that (i) consistent with previous studies, maltreatment types were highly interrelated and frequently co-occurred; (ii) symptom severity linearly increased with the number of maltreatment types experienced (more so for self-report vs inform…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighbourhood (text)
Assessment of neighbourhood-level socioeconomic status as a modifier of air pollution-asthma associations among children in Atlanta.
Background: A broad literature base provides evidence of association between air pollution and paediatric asthma. Socioeconomic status (SES) may modify these associations; however, previous studies have found inconsistent evidence regarding the role of SES.
Methods: Effect modification of air pollution-paediatric asthma morbidity by multiple indicators of neighbourhood SES was examined in Atlanta, Georgia. Emergency department (ED) visit data were obtained for 5-18 years old with a diagnosis of asthma in 20-county Atlanta during 2002-2008. Daily ZIP Code Tabulation Area (ZCTA)-level concentrations of ozone, nitrogen dioxide, fine particulate matter and elemental carbon were estimated using ambient monitoring data and emissions-based chemical transport model simulations. Pollutant-asthma associations were estimated using a case-crossover approach, controlling for temporal trends and meteo…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighbourhood (text)
Cohesive Neighborhoods Where Social Expectations Are Shared May Have Positive Impact On Adolescent Mental Health.
Adolescent mental health problems are associated with poor health and well-being in adulthood. We used data from a cohort of 2,264 children born in large US cities in 1998-2000 to examine whether neighborhood collective efficacy (a combination of social cohesion and control) is associated with improvements in adolescent mental health. We found that children who grew up in neighborhoods with high collective efficacy experienced fewer depressive and anxiety symptoms during adolescence than similar children from neighborhoods with low collective efficacy. The magnitude of this neighborhood effect is comparable to the protective effects of depression prevention programs aimed at general or at-risk adolescent populations. Our findings did not vary by family or neighborhood income, which indicates that neighborhood collective efficacy supports adolescent mental health across diverse population…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Space and the Social Environment.
Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people's stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant's home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were …
matched on Residence Characteristics (mesh), Urban Population (mesh), neighbourhood (text)
Race-Ethnicity, Poverty, Urban Stressors, and Telomere Length in a Detroit Community-based Sample.
Residents of distressed urban areas suffer early aging-related disease and excess mortality. Using a community-based participatory research approach in a collaboration between social researchers and cellular biologists, we collected a unique data set of 239 black, white, or Mexican adults from a stratified, multistage probability sample of three Detroit neighborhoods. We drew venous blood and measured telomere length (TL), an indicator of stress-mediated biological aging, linking respondents' TL to their community survey responses. We regressed TL on socioeconomic, psychosocial, neighborhood, and behavioral stressors, hypothesizing and finding an interaction between poverty and racial-ethnic group. Poor whites had shorter TL than nonpoor whites; poor and nonpoor blacks had equivalent TL; and poor Mexicans had longer TL than nonpoor Mexicans. Findings suggest unobserved heterogeneity bias…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Bocquier A, Cortaredona S, Boutin C, David A, Bigot A, Sciortino V, Nauleau S, Gaudart J, Giorgi R, Verger P (2014)MEDLINE-indexed journal, not yet read by usEuropean journal of public health18 citations Is exposure to night-time traffic noise a risk factor for purchase of anxiolytic-hypnotic medication? A cohort study.
Background: Studies suggest that road traffic noise increases risks of sleep disturbances, anxiety and depressive symptoms, but few have focused on psychotropic drug use. We examined whether exposure to night-time road traffic noise in Marseilles (France) is associated with an increased risk of purchasing anxiolytic or hypnotic medications.
Methods: Cohort of 190,617 inhabitants of Marseilles (aged 18-64 years) covered by the National Health Insurance Fund. We used the CadnaA noise propagation prediction model to calculate a potential road noise exposure indicator at dwellings for the night-period: Ln. Association between the number of purchases of anxiolytics-hypnotics in 2008-9 and the Ln was analysed with a zero-inflated negative binomial (ZINB) model adjusted for characteristics of individuals (sociodemographic, consultations with general practitioners, presence of chronic psychiatri…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighbourhood (text)
The influence of rural home and neighborhood environments on healthy eating, physical activity, and weight.
Despite the recognition that environments play a role in shaping physical activity and healthy eating behaviors, relatively little research has focused on rural homes and neighborhoods as important settings for obesity prevention. This study, conducted through community-based participatory research, used a social ecological model to examine how home and neighborhood food and physical activity environments were associated with weight status among rural-dwelling adults. Data were from a cross-sectional survey of White and African American adults (n = 513) aged 40-70 years living in rural southwest Georgia. Data were analyzed using measured variable path analysis, a form of structural equation modeling. The results support a social ecological approach to obesity prevention. Physical activity had a direct effect on BMI; self-efficacy, family support for physical activity, and household inven…
matched on Residence Characteristics (mesh), Rural Population (mesh), neighborhood (text)
Neighborhood disorder and telomeres: connecting children's exposure to community level stress and cellular response.
Our objective was to explore the utility of salivary telomere length (sTL) as an early indicator of neighborhood-level social environmental risk during child development. We therefore tested the hypothesis that sTL would be associated with markers of social stress exposure in children. Children age 4-14 from 87 neighborhoods were recruited through five urban schools in New Orleans, Louisiana, U.S. Data were collected at the level of the child, family/household, and neighborhood. DNA was obtained from saliva using commercially available kits and sTL was determined for 104 children using quantitative PCR. Analysis was performed on 99 children who had complete data including sTL, social environmental stress, and additional covariates. The mean sTL value was 7.4 T/S (telomere signal/single-copy signal) ratio units (±2.4, range = 2.5-18.0), and 4.7% of the variance in sTL was attributed to di…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
How big is my neighborhood? Individual and contextual effects on perceptions of neighborhood scale.
Neighborhood is a social and geographic concept that plays an increasingly important role in research and practice that address disparities in health and well-being of populations. However, most studies of neighborhoods, as well as community initiatives geared toward neighborhood improvement, make simplifying assumptions about boundaries, often relying on census geography to operationalize the neighborhood units. This study used geographic information system (GIS) tools to gather and analyze neighborhood maps drawn by residents of low-income communities in 10 cities. The median resident map size was approximately 30 percent smaller than the median census tract, but 25 percent of residents viewed their neighborhood as quite small (less than one-fifth of the typical census tract). Multi-level modeling showed significant within context variation in perceived neighborhood scale. Longer term …
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Associations between socioeconomic status and allostatic load: effects of neighborhood poverty and tests of mediating pathways.
Objectives: We examined relationships between neighborhood poverty and allostatic load in a low- to moderate-income multiracial urban community. We tested the hypothesis that neighborhood poverty is associated with allostatic load, controlling for household poverty. We also examined the hypotheses that this association was mediated by psychosocial stress and health-related behaviors.
Methods: We conducted multilevel analyses using cross-sectional data from a probability sample survey in Detroit, Michigan (n = 919) and the 2000 US Census. The outcome measure was allostatic load. Independent variables included neighborhood and household poverty, psychosocial stress, and health-related behaviors. Covariates included neighborhood and individual demographic characteristics.
Results: Neighborhood poverty was positively associated with allostatic load (P < .05), independent of household poverty…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Family income and childhood obesity in eight European cities: the mediating roles of neighborhood characteristics and physical activity.
Utilizing data from the Large Analysis and Review of European Housing and Health Status (LARES) research program conducted by the WHO in eight European cities (Forli, Vilnius, Ferreira do Alentejo, Bonn, Geneva, Angers, Bratislava, Budapest), we examined whether the well-documented inverse correlation between family income and children's BMI might be explained, in part, by access to open green space and ensuing physical activity. We found that household income was inversely related to BMI among 1184 children, ages 6-18 years of age. Utilizing structural equation modeling with statistical controls for age and gender, we found evidence for two indirect paths between household income and BMI. One indirect relationship operates successively through open green space and physical activity. The second path operates through physical activity alone. The child's height and weight as well as level …
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Neighborhood social cohesion and posttraumatic stress disorder in a community-based sample: findings from the Detroit Neighborhood Health Study.
Purpose: Posttraumatic stress disorder (PTSD) is common and debilitating. Although research has identified individual-level risk factors for PTSD, the role of macro-social factors in PTSD etiology remains unknown. This study tests whether perceived neighborhood social cohesion (NSC), measured at the both the individual and neighborhood levels, plays a role in determining past-year risk of PTSD among those exposed to trauma.
Methods: Data (n = 1,221) were obtained from an ongoing prospective epidemiologic study in the city of Detroit. Assessment of traumatic event exposure and PTSD was consistent with DSM-IV criteria. Generalized estimating equations (GEE) and logistic regression models were used to estimate the association of neighborhood-level perceived NSC with the risk of PTSD, adjusting for individual-level perceptions of NSC and other covariates.
Results: The odds of past-year PTSD …
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)
Young children in urban areas: links among neighborhood characteristics, weight status, outdoor play, and television watching.
Although research consistently demonstrates a link between residential context and physical activity for adults and adolescents, less is known about young children's physical activity. Using data from the U.S. Fragile Families and Child Wellbeing Study (N=1822, 51% male), we explored whether outdoor play and television watching were associated with children's body mass indexes (BMIs) at age five using OLS regression models, controlling for a wide array of potential confounders, including maternal BMI. We also tested whether subjective and objective neighborhood measures - socioeconomic status (from U.S. Census tract data), type of dwelling, perceived collective efficacy, and interviewer-assessed physical disorder of the immediate environment outside the home - were associated with children's activities, using negative binomial regression models. Overall, 19% of the sample were overweight…
matched on Residence Characteristics (mesh), Urban Population (mesh), neighborhood (text)