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Neighborhood economic conditions, social processes and self-rated health: A multilevel structural equation model

Luisa Franzini, PhD1, Margaret Caughy, PhD1, William Spears, PhD2, and Maria Eugenia Fernandez-Esquer, PhD1. (1) University of Texas School of Public Health, 1200 Herman Pressler, Houston, TX 77030, 713 500 9487, lfranzini@sph.uth.tmc.edu, (2) San Antonio Regional Campus, University of Texas School of Public Health, 7703 Floyd Curl Drive, Mail Code 7976, San Antonio, TX 78284

This paper explores the relationship between neighborhood impoverishment and self-rated health in a diverse set of neighborhoods in Texas. We develop and test a comprehensive model to explain the relationship of neighborhood SES to multiple dimensions of neighborhood social and physical characteristics as well as the pathways through which neighborhood social and physical characteristics influence individual health outcomes. Data were drawn from surveys obtained using a multistage probability sample in low/medium income “neighborhoods”, defined as census block group. The sample of 3,171 individuals represents 100 census block groups. Neighborhood processes were modeled as latent variables and multilevel structural equation models were used to estimate the relationships between neighborhood SES, neighborhood social and physical characteristics, social support and health behavior, and individual self-rated health. The results indicates that social and physical characteristics of neighborhoods (collective efficacy, social capital measured by trust and norms of reciprocity, social and physical disorder, social processes pertaining to children, neighborhood climate characterized by fear and racism) are determined by neighborhood structural factors and mediate the effects of neighborhood impoverishment on individual self-rated health. Neighborhood social processes and physical conditions are associated with neighborhood differences in social support and health behaviors but only partly mediate the relationships between social and physical characteristics and individual health. Individual factors, such as age, sex, and SES as well as health behavior and social support, remain strong predictors of self-rated health. The results of this study contribute to our understanding of how different neighborhood characteristics might affect individual health status.

Learning Objectives:

Keywords: Social Inequalities, Community Research

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Socioeconomic Status and Health

The 132nd Annual Meeting (November 6-10, 2004) of APHA