Determinants of Health: A Mediational Model of Socioeconomic Status, Neighborhood Safety, and Physical Activity

Individuals from low socioeconomic status (SES) backgrounds are more likely to experience negative health outcomes. The link between SES and health may be partially mediated by safety fears since perceptions of neighborhood conditions is linked to certain health outcomes. This study examined how SES is associated with health outcomes via the mediating effects of neighborhood safety concerns and physical activity. Data come from the California Health Interview Survey (CHIS) using a sample of 44,346 adults. Structural equation models indicated that the associations between SES and health outcomes appear to be partially mediated through concerns of neighborhood safety and physical activity, but differently for certain groups. Neighborhood safety's influence on physical activity was moderated by gender and age: older males with high safety fears reported less physical activity than older males with low safety fears, whereas older women reported similar levels of physical activity regardless of their safety concerns. A one point increase in SES (e.g., high school diploma to college), was associated with feeling more safe in one's neighborhood, but only for young individuals, regardless of gender. The largest effect in the prediction of mental health was age; the largest effects in the prediction of physical health were SES, physical activity, and age. Results of this study provide insights into how SES operates to affect health outcomes by suggesting key mediating variables. Implications from this study suggest that interventions to improve health might benefit from targeting certain demographic populations.