In the eyes of the beholder: Race, place and health

Abstract

Racial and ethnic health disparities are fundamentally connected to neighborhood quality. For example, as a result of historical systemic inequities, racial and ethnic minorities are more likely to live in neighborhoods with signs of physical disorder (e.g., graffiti, vandalism), and physically disordered environments have been noted to associate with increased risk for chronic illness. Degree of exposure to neighborhood disorder may alter peoples' perception of their neighborhoods, however, with those most exposed (e.g., historically marginalized racial/ethnic groups) perhaps perceiving less threat from signs of neighborhood disorder. The purpose of the present study was to examine the complex interrelationships between people and place by investigating whether exposure to neighborhood physical disorder relates to residents' (1) perceptions of neighborhood safety and (2) perceptions of their health, and (3) examining whether these links vary by race/ethnicity. Using 2016–2018 Health and Retirement Study (HRS) data, a representative sample of US adults aged 51 years and older (n = 9,080, mean age 68 years), we conducted a series of weighted linear regressions to examine the role of neighborhood disorder in relation to both perceived neighborhood safety and self-rated health. Results indicated that greater neighborhood physical disorder was statistically significantly related to feeling less safe among non-Hispanic Whites and Hispanics, but not non-Hispanic Blacks. Regarding self-rated health, neighborhood physical disorder was statistically significantly related to poorer health among all racial/ethnic groups. These findings suggest that, despite differential interpretation of neighborhood disorder as a threat to safety, this modifiable aspect of peoples' environment is related to poor health regardless of one's race/ethnicity.

Perceived neighborhood disorder and type 2 diabetes disparities in Hispanic, Black, and White Americans

“…Beyond individual characteristics, features of neighborhood environments are also associated with increased disease risk ( 12 , 13 ). In fact, the World Health Organization states that social determinants of health are linked to “the conditions in which people grow up, live, and age” and that inequality in these spaces can lead to poorer health outcomes across generations ( 14 ).…”

“…Beyond these observed neighborhood differences, researchers have begun realizing racial/ethnic differences in the interpretation of neighborhood disorder as a sign of personal threat ( 13 , 24 , 36 ). Non-Hispanic Whites report disorder more often than those from other racial/ethnic groups, for example, which some argue results from relatively low levels of exposure to disorder among non-Hispanic Whites to begin with ( 37 ).…”

“…One recent study observed that neighborhood physical disorder as rated by third parties was related to safety concerns, but only among non-Hispanic Whites and Hispanics, not non-Hispanic Blacks. However, neighborhood physical disorder was linked to poorer self-rated health among all three groups ( 13 ). These results suggested that, despite differences in interpretation of personal threat, ameliorating signs of physical disorder may be a worthy neighborhood intervention that benefits diverse populations.…”

“…Neighborhood environments may be an even stronger predictor of health in the context of older adulthood, as older adults may spend more time in their neighborhoods (16)(17)(18)(19). Specifically, neighborhood social and physical disorder is linked to poorer health among residents (13,(20)(21)(22)(23). Neighborhood disorder theory suggests that residents modify their behavior due to perceptions of threat toward safety and wellbeing (24,25).…”