142nd APHA Annual Meeting and Exposition

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Do social relationships protect agains adverse effects of neighborhood poverty on cumulative biologic risk?

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Amy J. Schulz, PhD , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Alana M.W. LeBron, MS , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Graciela B. Mentz, PhD , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Barbara A. Israel, DrPH , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Carmen A. Stokes, MSN, FNP , Nursing, University of Detroit Mercy, Detroit, MI
1) Background:

The conditions in which people are born, grow, live, work and age contribute to health inequities.  Residents of high poverty neighborhoods encounter multiple built and social environmental conditions that influence risk of adverse health outcomes.  We examine whether neighborhood level indicators of social relationships (e.g., social support at the neighborhood level) protect against adverse effects of neighborhood poverty on cumulative biologic risk (CBR), comprising indicators of cardiovascular and metabolic risk.

2) Methods:

Using data from the Healthy Environments Partnership (HEP) community survey (n=919) and systematic social observation of residential neighborhoods, we use multilevel models to test the hypothesis that social relationships are protective against CBR.  Level 1 = individual (e.g., age), level 2= rook (e.g., neighborhood social support), level 3- block group (neighborhood poverty).  Models control for observed neighborhood physical environment, and individual demographic and behavioral characteristics.

3) Results:

Residents of neighborhoods with higher average levels of social support had significantly lower CBR, above and beyond effects of individual social support, neighborhood poverty, observed neighborhood physical environments, and individual health-related behaviors.  Neighborhood participation, sense of community, and neighborhood satisfaction were not associated with CBR.

4) Conclusion/Discussion:

Neighborhood social relationships have been relatively unexplored as a social determinant of health.  These findings suggest that neighborhoods with higher aggregate levels of social support may be protective of health, above and beyond neighborhood poverty, neighborhood physical conditions, and individual characteristics.  Social policies or interventions that strengthen or support neighborhood level social support may offer promising opportunities to promote health.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe neighborhood poverty as a social determinant of cumulative biologic risk (a global indicator of health). Describe social relationships in the context of theoretical pathways linking social determinants of health to cumulative biologic risk. Identify potential intervention strategies to promote health through strengthening social relationships in the context of social determinants of health.

Keyword(s): Health Disparities/Inequities, Urban Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I serve as PI for the project, identified the research question and supervised data analysis. I have over 20 years experience conducting social research, including serving as PI for multiple NIH-funded research efforts focused on social determinants of urban health and health 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.