The Social Environment and Health: A Discussion of the Epidemiologic Literature

Abstract

The environment can be thought of in terms of physical and social dimensions. The social environment includes the groups to which we belong, the neighborhoods in which we live, the organization of our workplaces, and the policies we create to order our lives. There have been recent reports in the literature that the social environment is associated with disease and mortality risks, independent of individual risk factors. These findings suggest that the social environment influences disease pathways. Yet much remains to be learned about the social environment, including how to understand, define, and measure it. The research that needs to be done could benefit from a long tradition in sociology and sociological research that has examined the urban environment, social areas, social disorganization, and social control. We summarize this sociological literature and discuss its relevance to epidemiologic research.

Subjective Social Status and Functional Decline in Older Adults

“…A growing literature also links neighborhood socioeconomic characteristics to the health of its residents. [33][34][35][36] Subjective social status might help account for the effect of the larger community on a person's life in a way that standard measures of SES do not fully capture.…”

The association of self-reported neighborhood disorganization and social capital with adolescent alcohol and drug use, dependence, and access to treatment

“…The selection argument, drift hypothesis, or economic perspective argue that the observed community effect does not in fact exist independently of individuals, but rather reflects aggregated individual residential preferences. The drift hypothesis proposes that low socio-economic status (SES) does not cause poor health, but that poor health leads to low SES (Yen and Syme, 1999). Given that the majority of adolescents are not living independently, the drift hypothesis may not be directly relevant to adolescents or it may be distally related as a function of parental drug use.…”

Preventing drug misuse by young people: we need to do more than ‘just say no’

“…Characteristics of social environments have been found to affect health and wellbeing (Yen & Syme 1999). Modern developed societies are marked by individualism and libertarianism.…”