Associations of neighborhood problems and neighborhood social cohesion with mental health and health behaviors: The Multi-Ethnic Study of Atherosclerosis

Abstract

Few studies have investigated the specific features implicated in neighborhood-health associations. We examined associations between measures of neighborhood problems and neighborhood social cohesion with depression, smoking, drinking, and walking for exercise in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Neighborhoods were characterized according to participant self-report and aggregated measures based on other MESA participants. Individuals living in the least problematic neighborhoods were significantly less likely to be depressed, to smoke, or to drink. Less socially cohesive neighborhoods were associated with increased depression, smoking, and not walking for exercise. Results persisted after adjusting for individual-level variables. Each measure appeared to capture distinct features of the neighborhood and associations did not differ by race/ethnicity. Results for neighborhood problems were robust to the use of aggregate measures but results for social cohesion generally were not. Future work should determine the health effect of modifying specific features of the neighborhood context.

Differences in Quit Attempts and Cigarette Smoking Abstinence Between Whites and African Americans in the United States: Literature Review and Results From the International Tobacco Control US Survey

“…73 Those African Americans living in higher stress neighborhoods, and those living in less socially cohesive neighborhoods, are more likely to smoke. 74,75 Some evidence suggests that retail marketing of cigarettes is higher in African American neighborhoods. 76 Marketing of menthol cigarettes and little cigars and cigarillos are clearly higher in African American neighborhoods.…”

Assessing the Psychometric and Ecometric Properties of Neighborhood Scales in Developing Countries: Saúde em Beagá Study, Belo Horizonte, Brazil, 2008–2009

“…Several studies have documented associations between different health outcomes and neighborhood characteristics, after accounting for differences in individual-level characteristics across neighborhoods. Such associations have been reported for a diversity of health outcomes including cardiovascular diseases [7][8][9] , mortality 10,11 , mental health outcomes [12][13][14][15][16] , physical activity 17,18 , and perceived health 19 , among others [20][21][22] . Many studies have used census-based indicators, constructed by aggregating the socioeconomic characteristics of residents as proxies for the more specific neighborhood features hypothesized to be relevant to health.…”

Why the Neighborhood Social Environment Is Critical in Obesity Prevention

“…16 Social cohesion and social capital have been negatively associated with BMI and obesity but positively associated with physical activity among both adults and adolescents. 8,17,18 A positive perception of the neighborhood social environment may increase the likelihood of outdoor physical activity; parents, for example, may be more likely to allow their children to play outside. 19 Increased levels of collective efficacy and social cohesion provide more opportunities for modeling healthy behaviors in a supportive environment in addition to preventing deterioration of the physical environment (i.e., trash, street lights, graffiti) and promoting safety.…”