Where a person lives as a determinant of health.
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326 to 350 of 1,190The association between neighbourhood-level deprivation and depression: evidence from the south african national income dynamics study.
Background: Depression contributes substantially to the burden of disease in South Africa. Little is known about how neighbourhoods affect the mental health of the people living in them.
Methods: Using nationally representative data (N=11,955) from the South African National Income Dynamics Study and the South African Indices of Multiple Deprivation (SAIMD) modelled at small-area level, this study tested associations between neighbourhood-level deprivation and depression, after controlling for individual-level covariates.
Results: Results showed a significant positive association between neighbourhood-level deprivation and depression using the composite SAIMD (β = 0.31 (0.15); p=0.04) as well as the separate deprivation domains. Living environment deprivation (β =0.53 (0.16); p=0.001) and employment deprivation (β = 0.38 (0.13); p=0.004), respectively, were the two most salient domains i…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Associations between Perceived Neighborhood Walkability and Walking Time, Wellbeing, and Loneliness in Community-Dwelling Older Chinese People in Hong Kong.
This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged 60+ (n = 181). Walkability was measured using nine items selected from the Chinese version of the abbreviated Neighborhood Environment Walkability Scales (NEWS) and NEWS for Chinese Seniors. Outcomes were walking time, physical activity, wellbeing (life satisfaction, happiness, sense of purpose and meaning in life), and loneliness. The mean age of the participants was 71.7 ± 7.8 years. Walkability was positively associated with walking time (p = 0.001, p for trend <0.001) but not with physical activity. After adjusting for socio-demographic ch…
matched on Residence Characteristics (mesh), Environment Design (mesh), neighborhood (text)
Neighborhood social and physical environments and type 2 diabetes mellitus in African Americans: The Jackson Heart Study.
Using data from Jackson Heart Study, we investigated the associations of neighborhood social and physical environments with prevalence and incidence of type 2 diabetes mellitus (T2DM) in African Americans (AA). Among non-diabetic participants at baseline (n=3670), 521 (14.2%) developed T2DM during a median follow-up of 7.3 years. Measures of neighborhood social environments, and food and physical activity resources were derived using survey-and GIS-based methods. Prevalence ratios (PR) and Hazard ratios (HR) were estimated using generalized estimating equations and Cox proportional hazards models. Higher neighborhood social cohesion was associated with a 22% lower incidence of T2DM while higher density of unfavorable food stores was associated with a 34% higher incidence of T2DM after adjusting for individual-level risk factors (HR=0.78 [95% CI:0.62, 0.99] and HR=1.34 [1.12, 1.60], respe…
matched on Residence Characteristics (mesh), Environment Design (mesh), neighborhood (text)
Neighborhood Environment and Falls among Community-Dwelling Older Adults.
Background: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night). Methods: Data were analyzed from 9259 participants over four biennial waves (2006-2012) of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 65 and older in the United States. Results: In models adjusting for demographic and health-related covariates, a one-unit increase in neighborhood social cohesion was associated with 4% lower odds of experiencing a single fall (odds ratio (OR): 0.96, 95% confidence interv…
matched on Residence Characteristics (mesh), Environment Design (mesh), neighborhood (text)
McEachan RR, Prady SL, Smith G, Fairley L, Cabieses B, Gidlow C, Wright J, Dadvand P, van Gent D, Nieuwenhuijsen MJ (2016)MEDLINE-indexed journal, not yet read by usJournal of epidemiology and community health183 citations The association between green space and depressive symptoms in pregnant women: moderating roles of socioeconomic status and physical activity.
Background: The current study explored the association between green space and depression in a deprived, multiethnic sample of pregnant women, and examined moderating and mediating variables.
Method: 7547 women recruited to the 'Born in Bradford' cohort completed a questionnaire during pregnancy. A binary measure of depressive symptoms was calculated using a validated survey. Two green space measures were used: quintiles of residential greenness calculated using the normalised difference vegetation index for three neighbourhood sizes (100, 300 and 500 m buffer zones around participant addresses); access to major green spaces estimated as straight line distance between participant address and nearest green space (>0.5 hectares). Logistic regression analyses examined relationships between green space and depressive symptoms, controlling for ethnicity, demographics, socioeconomic status (SE…
matched on Residence Characteristics (mesh), Environment Design (mesh), neighbourhood (text)
Long-term effects of neighbourhood deprivation on diabetes risk: quasi-experimental evidence from a refugee dispersal policy in Sweden.
Background: Although studies have shown associations between neighbourhood quality and chronic disease outcomes, such associations are potentially confounded by the selection of different types of people into different neighbourhood environments. We sought to identify the causal effects of neighbourhood deprivation on type 2 diabetes risk, by comparing refugees in Sweden who were actively dispersed by government policy to low-deprivation, moderate-deprivation, or high-deprivation neighbourhoods.
Methods: In this quasi-experimental study, we analysed national register data for refugees who arrived in Sweden aged 25-50 years, at a time when the government policy involved quasi-random dispersal of refugees to neighbourhoods with different levels of poverty and unemployment, schooling, and social welfare participation. Individuals in our sample were assigned to a neighbourhood categorised as…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Denny S, Lewycka S, Utter J, Fleming T, Peiris-John R, Sheridan J, Rossen F, Wynd D, Teevale T, Bullen P, Clark T (2016)MEDLINE-indexed journal, not yet read by usInternational journal for equity in health32 citations The association between socioeconomic deprivation and secondary school students' health: findings from a latent class analysis of a national adolescent health survey.
Background: The aims of this study were to examine indicators of socioeconomic deprivation among secondary school students and to determine associations between household poverty, neighbourhood deprivation and health indicators.
Methods: Data were from a nationally representative sample of 8500 secondary school students in New Zealand who participated in a health survey in 2012. Latent class analyses were used to group students by household poverty based on nine indicators of household socioeconomic deprivation: no car; no phone; no computer; their parent/s worry about not having enough money for food; more than two people sharing a bedroom; no holidays with their families; moving home more than twice that year; garages or living rooms used as bedrooms; and, no parent at home with employment. Multilevel generalized linear models were used to estimate the cross-level interaction between h…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Interactions between Neighborhood Social Environment and Walkability to Explain Belgian Older Adults' Physical Activity and Sedentary Time.
This study examined associations between neighborhood social factors and physical activity (PA) and sedentary behavior (SB) in older adults. Furthermore, possible moderating effects of neighborhood walkability were explored. Data from 431 community-dwelling Belgian older adults (≥65 years) were analyzed. Neighborhood social factors included measures of neighboring, social trust and cohesion and social diversity. Neighborhood walkability was measured objectively. Outcome measures were self-reported weekly minutes of domain-specific walking and TV viewing, and accelerometer-assessed weekly minutes of moderate-to-vigorous physical activity (MVPA) and overall SB. A higher frequency of talking to neighbors was associated with higher levels of self-reported walking for transport and for recreation. Moderation analyses showed that only in highly-walkable neighborhoods, higher social diversity o…
matched on Residence Characteristics (mesh), Environment Design (mesh), neighborhood (text)
Residential exposure to visible blue space (but not green space) associated with lower psychological distress in a capital city.
As urbanisation escalates globally, urban neighbourhood features which may improve physical and mental health are of growing importance. Using a cross-sectional survey of adults and the application of novel geospatial techniques, this study investigated whether increased visibility of nature (green and blue space) was associated with lower psychological distress (K10 scores), in the capital city of Wellington, New Zealand. To validate, we also tested whether visibility of blue space was associated missing teeth in the same sample. Cluster robust, linear regression models were fitted to test the association between visibility of nature and K10 scores, adjusted for age, sex, personal income, neighbourhood population density, housing quality, crime and deprivation. Higher levels of blue space visibility were associated with lower psychological distress (β=-0.28, p<0.001). Importantly, blue …
matched on Residence Characteristics (mesh), Environment Design (mesh), neighbourhood (text)
Using Walk Score™ and Neighborhood Perceptions to Assess Walking Among Middle-Aged and Older Adults.
We aimed to determine the relationship between neighborhood characteristics (walkability, cohesion/safety) and recommended activity levels among community-dwelling middle-aged and older adults. Subjective and objective data on 394 individuals aged ≥50 years were used to assess the likelihood of walking ≥150 min/week. Environmental factors associated with a greater likelihood of any walking ≥150 min/week included living in a neighborhood with high perception of cohesion/safety versus low, living in walkable areas versus car-dependent, and living in an area with a low-moderate median income versus the lowest. Middle-aged and older adults were more likely to walk ≥150 min/week in a walkable, perceived safe/cohesive neighborhood. Identifying neighborhood factors associated with promoting walking among this population can enable stakeholders (e.g., researchers, planners, and policy makers) to…
matched on Residence Characteristics (mesh), Environment Design (mesh), neighborhood (text)
The influence of neighbourhood-level socioeconomic deprivation on cardiovascular disease mortality in older age: longitudinal multilevel analyses from a cohort of older British men.
Background: Evidence from longitudinal studies on the influence of neighbourhood socioeconomic factors in older age on cardiovascular disease (CVD) mortality is limited. We aimed to investigate the prospective association of neighbourhood-level deprivation in later life with CVD mortality, and assess the underlying role of established cardiovascular risk factors.
Methods: A socially representative cohort of 3924 men, aged 60-79 years in 1998-2000, from 24 British towns, was followed up until 2012 for CVD mortality. Quintiles of the national Index of Multiple Deprivation (IMD), a composite score of neighbourhood-level factors (including income, employment, education, housing and living environment) were used. Multilevel logistic regression with discrete-time models (stratifying follow-up time into months) were used.
Results: Over 12 years, 1545 deaths occurred, including 580 from CVD. The…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Jokela M (2015)MEDLINE-indexed journal, not yet read by usJournal of epidemiology and community health40 citations Does neighbourhood deprivation cause poor health? Within-individual analysis of movers in a prospective cohort study.
Background: Neighbourhood deprivation has been associated with poor health. The evidence for social causation, however, remains scarce because selective residential mobility may also create neighbourhood differences. The present study examined whether individuals had poorer health when they were living in a deprived neighbourhood compared to another time when the same individuals were living in a less deprived neighbourhood.
Methods: Participants were from the British Household Panel Survey prospective cohort study with 18 annual measurements of residential location and self-reported health outcomes between 1991 and 2009 (n=137 884 person-observations of 17 001 persons in England). Neighbourhood deprivation was assessed concurrently with health outcomes using the Index of Multiple Deprivation at the geographically detailed level of Lower Layer Super Output Areas. The main analyses were r…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Individual and community determinants of neonatal mortality in Ghana: a multilevel analysis.
Background: Neonatal mortality is a global challenge; identification of individual and community determinants associated with it are important for targeted interventions. However in most low and middle income countries (LMICs) including Ghana this problem has not been adequately investigated as the impact of contextual factors remains undetermined despite their significant influence on under-five mortality and morbidity.
Methods: Based on a modified conceptual framework for child survival, hierarchical modelling was deployed to examine about 6,900 women, aged 15 - 49 years (level 1), nested within 412 communities (level 2) in Ghana by analysing combined data of the 2003 and 2008 Ghana Demographic and Health Survey. The aim was to identify individual (maternal, paternal, neonatal, antenatal, delivery and postnatal) and community (socioeconomic disadvantage communities) determinants associ…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Mortality following stroke during and after acute care according to neighbourhood deprivation: a disease registry study.
Background: Neighbourhood deprivation has been shown to be inversely associated with mortality 1 month after stroke. Whether this disadvantage begins while patients are still receiving acute care is unclear. We aimed to study mortality after stroke specifically in the period while patients are under acute care and the ensuing period when they are discharged to home or other care settings.
Methods: Our sample includes 1760 incident strokes (mean age 75, 48% men, 86% ischaemic) identified between 1998 and 2010 by the population-based stroke registry of Dijon (France). We used Cox regression to study all-cause mortality up to 90 days after stroke occurrence.
Results: Overall, 284 (16.1%) patients died during the 90 days following stroke. Prior to stroke, risk factors prevalence (eg, high blood pressure and diabetes) and acute care management did not vary across deprivation levels. There was…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Foodscapes of southern Ontario: neighbourhood deprivation and access to healthy and unhealthy food retail.
Objectives: We examined whether access to retail sources of healthy and unhealthy food varies according to level of neighbourhood material deprivation in three Ontario regions and whether urban form characteristics help to explain any such variations.
Methods: Food retail (FR) outlets were identified from a commercial database for 804 urban neighbourhoods in Toronto, Brampton/Mississauga and Hamilton, Ontario. The median number of healthy and unhealthy FR outlets and percentage of outlets that were unhealthy were derived using 720-metre network buffers based on dissemination blocks and aggregated up to neighbourhood level (census tract). The 2006 Canadian Census was used to derive a composite index of material deprivation and three urban form measures related to zoning and urbanization. Multivariate regression models assessed the association between material deprivation, urban form and e…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Bodicoat DH, O'Donovan G, Dalton AM, Gray LJ, Yates T, Edwardson C, Hill S, Webb DR, Khunti K, Davies MJ, Jones AP (2014)MEDLINE-indexed journal, not yet read by usBMJ open78 citations The association between neighbourhood greenspace and type 2 diabetes in a large cross-sectional study.
Objective: To investigate the relationship between neighbourhood greenspace and type 2 diabetes.
Design: Cross-sectional.
Setting: 3 diabetes screening studies conducted in Leicestershire, UK in 2004-2011. The percentage of greenspace in the participant's home neighbourhood (3 km radius around home postcode) was obtained from a Land Cover Map. Demographic and biomedical variables were measured at screening.
Participants: 10,476 individuals (6200 from general population; 4276 from high-risk population) aged 20-75 years (mean 59 years); 47% female; 21% non-white ethnicity.
Main outcome measure: Screen-detected type 2 diabetes (WHO 2011 criteria).
Results: Increased neighbourhood greenspace was associated with significantly lower levels of screen-detected type 2 diabetes. The ORs (95% CI) for screen-detected type 2 diabetes were 0.97 (0.80 to 1.17), 0.78 (0.62 to 0.98) and 0.67 (0.49 to 0.9…
matched on Residence Characteristics (mesh), Environment Design (mesh), neighbourhood (text)
The protective effects of neighborhood collective efficacy on adolescent substance use and violence following exposure to violence.
Research has demonstrated that exposure to violence can result in many negative consequences for youth, but the degree to which neighborhood conditions may foster resiliency among victims is not well understood. This study tests the hypothesis that neighborhood collective efficacy attenuates the relationship between adolescent exposure to violence, substance use, and violence. Data were collected from 1,661 to 1,718 adolescents participating in the Project on Human Development in Chicago Neighborhoods, who were diverse in terms of sex (51% male, 49% female), race/ethnicity (48% Hispanic, 34% African American, 14% Caucasian, and 4% other race/ethnicity), and age (mean age 12 years; range 8-16). Information on neighborhood collective efficacy was obtained from adult residents, and data from the 1990 U.S. Census were used to control for neighborhood disadvantage. Based on hierarchical model…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighborhood (text)
The impact of neighbourhood deprivation on adolescent violent criminality and substance misuse: a longitudinal, quasi-experimental study of the total Swedish population.
Background: A number of studies suggest associations between neighbourhood characteristics and criminality during adolescence and young adulthood. However, the causality of such neighbourhood effects remains uncertain.
Methods: We followed all children born in Sweden from 1975-1989 who lived in its three largest cities by the age of 15 years and for whom complete information was available about individual and contextual factors (N = 303 465). All biological siblings were identified in the sample (N = 179 099). Generalized linear mixed-effects models were used to assess the effect of neighbourhood deprivation on violent criminality and substance misuse between the ages of 15 and 20 years, while taking into account the cross-classified data structure (i.e. siblings in the same families attending different schools and living in different neighbourhoods at age 15).
Results: In the crude mode…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Adolescents' utilisation of psychiatric care, neighbourhoods and neighbourhood socioeconomic deprivation: a multilevel analysis.
Mental health problems among adolescents have become a major public health issue, and it is therefore important to increase knowledge on the contextual determinants of adolescent mental health. One such determinant is the socioeconomic structure of the neighbourhood. The present study has two central objectives, (i) to examine if neighbourhood socioeconomic deprivation is associated to individual variations in utilisation of psychiatric care in a Swedish context, and (ii) to investigate if neighbourhood boundaries are a valid construct for identifying contexts that influence individual variations in psychiatric care utilization. Data were obtained from the Longitudinal Multilevel Analysis in Scania (LOMAS) database. The study population consists of all boys and girls aged 13-18 years (N=18,417), who were living in the city of Malmö, Sweden, in 2005. Multilevel logistic regression analysi…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
An ecological study investigating the association between access to urban green space and mental health.
Objectives: This study aims to find whether proximity to urban green spaces is associated with human mental health.
Study design: A cross-sectional examination of the relationship between access to urban green spaces and counts of anxiety/mood disorder treatments amongst residents (aged 15 years and over) in Auckland City, New Zealand.
Methods: Anxiety/mood disorder treatment counts by three age groups were aggregated to 3149 small area units in Auckland. Six measures of green space access were derived using GIS techniques involving total green spaces and useable green spaces. Negative binomial regression models have been fitted to test the relationship between access to green space and area-level anxiety/mood disorder treatment counts, adjusted for age and area-level deprivation.
Results: Anxiety/mood disorder treatment counts were associated with three green space measures. The proport…
matched on Residence Characteristics (mesh), Environment Design (mesh), neighbourhood (text)
The psychosocial pathway to mental well-being at the local level: investigating the effects of perceived relative position in a deprived area context.
Background: The study investigated whether perceived relative position was associated with mental well-being for people living in deprived areas, as a contribution to debates about income inequality, relative deprivation and health.
Methods: A survey of 4615 residents of deprived areas of Glasgow measured mental well-being using the WEMWBS scale. Perceived relative position was assessed locally and across wider society in relation to housing, neighbourhood and standard of living. Personal and dwelling characteristics were controlled for.
Results: Mental well-being was found to be positively associated with: perceived relative quality (RR 4.1, 95% CI 2.4 to 6.8) and status (RR 7.1, 95% CI 4.5 to 11.1) of the home; perceived internal reputation of the neighbourhood (RR 4.9, 95% CI 2.9 to 8.2), though not external reputation; and perceived relative standard of living (RR 5.2, 95% CI 3.2 to …
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Deprived yet healthy: neighbourhood-level resilience in New Zealand.
Geographical inequalities in health are omnipresent with health and related behaviours typically worse in socioeconomically deprived places. However, this is not always true. Deprived places with unexpectedly good health outcomes, or what might be considered 'resilient' places, have been noted. Few studies have quantitatively examined resilience in neighbourhoods or investigated potential explanations for this resilience. This paper examines the paradox of low mortality despite high social deprivation in New Zealand neighbourhoods and considers possible neighbourhood characteristics that contribute to unanticipated positive health outcomes. Using area-level mortality (2005-2007) and socioeconomic data, we developed the Resilience Index New Zealand to quantify neighbourhood levels of resilience across the country. We then examined relationships between this measure and a suite of built, p…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Residential mobility, neighbourhood deprivation and children's behaviour in the UK.
Using data from the first two waves (in 2001/02 and 2004) of the UK's Millennium Cohort Study (MCS), we attempted to separate the effect of residential mobility from the effect of neighbourhood deprivation on children's emotional and behavioural problems. Our sample was 23,162 children (aged 3-16 years) clustered in 12,692 families. We measured neighbourhood deprivation with the Index of Multiple Deprivation, a measure of neighbourhood-level socio-economic disadvantage, and residential mobility as household move between waves. Being in a lower deprivation neighbourhood at Wave 1 was related to lower scores of both emotional and behavioural problems 2 years later, even after adjustment for child's age and sex, family adversity, family structure and maternal psychological distress. However, children whose families subsequently moved-even within or between lower deprivation neighbourhoods-w…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
Why residents of Dutch deprived neighbourhoods are less likely to be heavy drinkers: the role of individual and contextual characteristics.
Background: Earlier research has shown that residents of Dutch deprived neighbourhoods drink less alcohol than people in other areas. We aimed to assess the role of individual and neighbourhood characteristics in a cross-sectional, nationwide, multilevel study.
Methods: Individual data of 30,117 Dutch adults, living in 1722 neighbourhoods across the Netherlands, were obtained from the 2004 to 2009 national health survey (POLS). Chronic heavy alcohol consumption was measured as ≥14 drinks/week for women and ≥21 for men, and episodic heavy drinking as ≥6 drinks/day at least once a week. Neighbourhood deprivation was dichotomous; deprived districts as selected by the Dutch government versus other areas. Multilevel logistic regression models of the association between deprivation and heavy drinking were corrected for age, gender, household composition, population density and potential predic…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)
"Safe Going": the influence of crime rates and perceived crime and safety on walking in deprived neighbourhoods.
Few studies have simultaneously examined the relationship of levels of recorded crime, perceptions of crime and disorder, and safety from crime with rates of physical activity. We developed a series of multilevel ordinal regression models to examine these aspects in relation to self-reported neighbourhood walking frequency in a cross-sectional sample of 3824 British adults from 29 deprived neighbourhoods in Glasgow, UK. Perceptions of several serious local antisocial behaviours (drunkenness and burglary) and feelings of personal safety (feeling safe in the home and if walking alone in the local area at night) were consistently associated, respectively, with less and more frequent walking. Conversely, perceiving drug dealing or drug use as a serious problem was associated with walking more frequently. There was a small but significant association between walking frequency in neighbourhood…
matched on Residence Characteristics (mesh), Poverty Areas (mesh), neighbourhood (text)