Linking perceptions of neighbourhood to health in Hamilton, Canada

Abstract

Study objective: To investigate the association between perceptions of neighbourhood physical and social characteristics and three health outcomes (self assessed health status, chronic conditions, and emotional distress). Design: Cross sectional survey data analysed in small neighbourhoods. Setting: Hamilton, Ontario, Canada, a medium sized industrial city, located at the western end of Lake Ontario (population at the time of the study about 380 000). Participants: Random sample of 1504 adults aged 18 years and older residing in four contrasting neighbourhoods. Main results: Significant differences across the four neighbourhoods are apparent in self assessed health status and emotional distress, but not in chronic conditions. Neighbourhoods with lower SES reported poorer health and more emotional distress. Perceptions of the physical environment dominated social concerns in all neighbourhoods. For all three health outcomes, individual risk factors followed expectations, with measures of poverty, age, and lifestyle all significantly associated with poor health outcomes. Physical environmental problems were positively and significantly associated with poor physical and emotional health. Specifically, people reporting they dislike aspects of their neighbourhood's physical environment are 1.5 times more likely to report chronic health conditions (OR 1.56, 95% CI 1.19 to 2.05), while those reporting physical likes with their neighbourhood are less likely to report fair/poor health (OR 0.50, 95% CI 0.28 to 0.90) or emotional distress (OR 0.45, 95% CI 0.26 to 0.80).Conclusions: These results demonstrate the importance of neighbourhood perceptions as a determinant of health, as well as conventional factors such as low income, lifestyle, and age. The dominance of physical environmental concerns may have arisen from the industrial nature of Hamilton, but this result merits further investigation.

Association of perceived neighborhood problems and census tract income with poor self-rated health in adults: a multilevel approach

“…Operationalizing specific measures of the characteristics of local areas hypothesized to be important for living a healthy life provides a more focused approach than general measures of deprivation in the search for area effects 26 . Thus, more emphasis should be given to residents' perceptions of physical environmental factors in the formulation of local public health polices 45 . Contributors D. A. Höfelmann participated in the study design, including data quality control, supervised the fieldwork activities, performed the multilevel analysis of the data, and was responsible for the study's analytic strategy.…”

The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal

“…As Cummins, Curtis, Diez-Roux, and argue, information is required concerning the time of exposure to different contexts in space and time, if the aim is to further our knowledge of environmental effects on health. Moreover, we are unable to measure residents' perceptions and reports, usually related with health and health-related behaviours (Van Lenthe et al, 2005;Wilson et al, 2004). Therefore, an effort must be made to generate and collect data concerning individual perceptions of neighbourhood, which can be achieved by integrating qualitative research into our quantitative approach.…”

Income-Related Health Inequalities in Korea

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