How do neighborhoods influence health? Clues from the qualitative literature

With widespread availability of multilevel modeling software and detailed administrative geographic data, few topics have received more attention in the literature recently than neighborhoods and health. Although findings vary, a majority of studies have found independent neighborhood effects on health. However, researchers generally have limited access to data to help them understand the underlying causal mechanisms. While there are comparatively fewer qualitative studies on neighborhoods and health, very rich qualitative data have been collected. Because it is unlikely that all quantitative researchers can conduct their own formative research and collect primary data, reviewing the qualitative studies is a necessary step in informing quantitative methods and gaining clues about causal pathways. We systematically examined qualitative studies (fifteen in total) that sought to understand how adults view and interact with their neighborhoods and how these interactions may influence health. PubMed, Google Scholar, and social science databases were searched. Search terms included ‘neighborhood,' ‘health,' ‘qualitative,' ‘ethnography,' ‘grounded theory,' ‘community,' ‘social capital,' and ‘healthcare.' The studies included in this review encompassed a variety of qualitative methods including phenomenology, case studies, grounded theory, community-based participatory research (CBPR), ethnography, and mixed methods. While the methodologies, samples, data collection tools, and study quality varied widely, the general themes that emerged included: social capital, social networks, the meaning of neighborhoods, amenities and liabilities associated with neighborhoods, coping with issues such as poverty, and neighborhood stressors. Areas for future exploration and how these findings may help inform quantitative studies are discussed.