Examining the relationship between social integration and neighborhood poverty: An analysis of nhanes III

Background: Social integration, defined as number and frequency of social ties, is associated with various health outcomes. There is also growing evidence of the importance of neighborhood contexts, such as level of poverty, on health. We examined how neighborhood poverty structures two dimensions of social integration: integration with neighbors and more general integration with family/ friends. Methods: We examined data from the Third National Health and Nutrition Examination Survey (NHANES III) geocoded and matched to census tracts, serving as neighborhood proxies. We assessed social integration using a modified version of the social network index (SNI) and neighborhood integration based on the number of visits with neighbors. We operationalized neighborhood poverty as the proportion of residents in a census tract living below the poverty level. We analyzed data using bivariate methods as well as logistic regression models that accounted for the complex survey design. Results: When controlling for individual-level factors, living in high poverty neighborhoods was associated with 47% (95% CI: 1.15, 1.88) greater odds of having a low score on the SNI when compared with those living in more affluent neighborhoods. In contrast, living in a high poverty neighborhood significantly decreased odds (OR=0.72, 95% CI: 0.55, 0.93) of having fewer visits with neighbors. Discussion: Compared with affluent neighborhoods, living in high poverty neighborhoods is associated with having fewer social ties generally but also with more visits with neighbors. These results merit further exploration as they suggest that neighborhood poverty may influence social integration in different ways and may lead to varying effects on health.