The importance of social context: Neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders

Abstract

This study examines the relationship among neighborhood stressors, stress-buffering mechanisms, and likelihood of alcohol, drug, and mental health (ADM) disorders in adults from 60 US communities (n=12,716). Research shows that larger support structures may interact with individual support factors to affect mental health, but few studies have explored buffering effects of these neighborhood characteristics. We test a conceptual model that explores effects of neighborhood stressors and stress-buffering mechanisms on ADM disorders. Using Health Care for Communities with census and other data, we found a lower likelihood of disorders in neighborhoods with a greater presence of stress-buffering mechanisms. Higher neighborhood average household occupancy and churches per capita were associated with a lower likelihood of disorders. Cross-level interactions revealed that violence-exposed individuals in high crime neighborhoods are vulnerable to depressive/anxiety disorders. Likewise, individuals with low social support in neighborhoods with high social isolation (i.e., low-average household occupancy) had a higher likelihood of disorders. If replicated by future studies using longitudinal data, our results have implications for policies and programs targeting neighborhoods to reduce ADM disorders.

Neighborhood Violence and its Association with Mothers’ Health: Assessing the Relative Importance of Perceived Safety and Exposure to Violence

“…The use of these measures appears to vary by outcome, with studies exploring general health or physical activity tending to focus on perceptions of neighborhood safety, studies investigating mental health measuring exposure to violence, and multi-community studies using actual measures of crimes or disorder. 2,3,6,14,17,23 While the selective use of these measures seems to be reflective of a hypothesized relationship, researchers do not often articulate their reasons for choosing a certain measure of neighborhood violence.…”

“…[9][10][11][12][13] Neighborhoods with high violence are thought to encourage isolation and therefore inhibit the social support needed to cope with stressful events. 14,15 Adolescents and adults living in violent neighborhoods have a greater risk for mental health disorders. 14,[16][17][18] To cope with stress, individuals may turn to risktaking behaviors.…”

“…14,15 Adolescents and adults living in violent neighborhoods have a greater risk for mental health disorders. 14,[16][17][18] To cope with stress, individuals may turn to risktaking behaviors. Exposure to violent neighborhoods has been associated with increased substance abuse, sexual risk-taking behaviors, and smoking as well as risky driving practices.…”

Measuring a neighborhood affluence-deprivation continuum in urban settings: Descriptive findings from four US cities

“…As discussed above, the same analogy may be used to infer a potential conflict of interest in the use of composite measure (e.g., Diez Roux et al 2001;Krieger et al 2003;Singh 2003;Winkleby and Cubbin 2003;Messer et al 2006) versus single measure (e.g., Galea et al 2007;Stockdale et al 2007;Tonorezos et al 2008;Sallis et al 2009;Black and Macinko 2010;King et al 2011) of neighborhood socioeconomic characteristics in previous studies. Figures 1 through 4 suggest that an area-based median household (or family) income in a regression analysis would convey the same information as that of selected composite measures considered in this study, despite the conceptual and theoretical differences.…”

“…For instance, area-based indexes of socioeconomic advantage (SEA) (Diez Roux et al 2001), socioeconomic status (SES) (Winkleby and Cubbin 2003), socioeconomic position (SEP) (Krieger et al 2003), socioeconomic deprivation (SED) (Singh 2003), and deprivation (DEP) (Messer et al 2006), among others, have been developed by different authors in the US (Table 1). Of equal importance, a single measure of neighborhood socioeconomic characteristics (i.e., an area-based median household or median family income) has also been used in some studies (e.g., Galea et al 2007;Stockdale et al 2007;Tonorezos et al 2008;Sallis et al 2009;Black and Macinko 2010;King et al 2011) instead of a composite measure. Therefore, a natural question arises: do single and composite measures of neighborhood socioeconomic characteristics capture the same dimension of neighborhood context?…”