287447
Pathways linking neighborhood socioeconomic context to self-rated health in African americans in houston, TX
Wednesday, November 6, 2013
: 8:56 a.m. - 9:14 a.m.
Larkin L. Strong, PhD, MPH,
Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
Jian Wang, PhD,
Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX
Seann D. Regan, MA,
Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
Luisa Franzini, PhD,
Management, Policy and Community Health Division, University of Texas School of Public Health, Houston, TX
David W. Wetter, PhD,
Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
Lorraine R. Reitzel, PhD,
Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
Lorna H. McNeill, PhD, MPH,
Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
Background: Although considerable research has demonstrated associations between neighborhood contextual factors and health-related outcomes, the mechanisms through which neighborhoods influence health are not well understood. Building on empirical and theoretical research, this study investigates mediational pathways linking neighborhood economic deprivation to health that include perceived neighborhood problems and neighborhood social cohesion as possible mediators. Methods: Cross-sectional data were collected from a church-based sample of African American adults (n=1,374; 75% female; mean age=45 years) in 2009. Neighborhood data were derived from the 2006-2010 American Community Survey. A neighborhood deprivation index comprised of 11 commonly used Census tract-level variables was developed using principal components analysis. Generalized estimating equations assessed the direct association between neighborhood deprivation and self-rated health (SRH). Monte Carlo confidence intervals were used to test the significance of mediational pathways. Analyses controlled for participant sociodemographics. Results: Greater neighborhood deprivation was associated with reporting worse health (OR=1.29; 95% CI: 1.02, 1.65). Neighborhood deprivation was inversely associated with social cohesion and positively associated with neighborhood problems. Both of these variables were, in turn, associated with SRH, with greater social cohesion predicting better health, and increased neighborhood problems predicting worse health. Single mediation models revealed that both social cohesion (OR=1.04; 95% CI: 1.01, 1.09) and neighborhood problems (OR=1.09; 95% CI: 1.01, 1.18) mediated the association between neighborhood deprivation and SRH. Conclusions: Findings emphasize the importance of the neighborhood socioeconomic context to neighborhood conditions and social cohesion as potential pathways influencing health. These attributes should be considered in the development of efforts to address neighborhood-based disparities in health.
Learning Areas:
Epidemiology
Social and behavioral sciences
Learning Objectives:
Discuss the importance of understanding the mechanisms through which neighborhood characteristics may impact individual health.
Describe the relationships between neighborhood economic deprivation, neighborhood problems, neighborhood social cohesion, and individual health.
Discuss directions for future research to further enhance understanding of how neighborhood socioeconomic contexts influence health.
Keyword(s): Minority Health, Environmental Justice
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I have worked on multiple studies investigating the relationships among neighborhood contextual factors and health or health behaviors. I have a particular interest in understanding the mechanisms through which neighborhood contexts influence health and contribute to racial/ethnic and socioeconomic disparities.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
