You can count on me, kid: Social cohesion and the health of youth in urban environments

The health of people is influenced by the characteristics of the places they live and the social capital generated by their interactions with others in the community. While urban policy, social work and public health are old friends, in recent years they have been reacquainted though the concept of social determinants of health – those factors that determine the distribution of both resources and health within a geographic area. Using data from the 2008 Arizona Health Survey, this paper assesses the impact of perceived neighborhood social cohesion on reported health status of youth (age 0 to17; N=624). Findings indicate that positive social cohesion is strongly associated with both better health status and access to care. Multiple regression analysis is used to explore the more subtle effects of social cohesion and perceived neighborhood safety on health status and access to care. Findings suggest that certain dimensions of social cohesion such as community parenting are positively associated with youths' health (OR=2.91; p-value=0.004), while others such as reciprocity may act as protective factors among residents who do not have a usual source of care (OR=3.49; p-value=0.032). This research contributes to a growing body of evidence about the role of neighborhood social cohesion and social capital as mediating factors in the distribution of health and health outcomes, and suggests that the formal and informal social connections which enhance these factors within communities have the potential to improve the health status of urban youth.