Association of perceived neighborhood problems and census tract income with poor self-rated health in adults: a multilevel approach

Abstract

Neighborhood problems constitute sources of chronic stress that may increase the risk of poor self-rated health. The associations of census tract level income and perceived neighborhood problems with self-rated health were examined in Florianópolis, Santa Catarina State, Brazil (1,720 adults). Odds ratios (OR) and their 95% confidence intervals (95%CI) of poor self-rated health were estimated through multilevel models. Residents in census tracts in the lower and intermediate tertiles of income reported poorer health than those in the highest tertile. OR of reporting poorer health was 2.44 (95%CI: 2.35- 2.54) in the higher tertile of social disorder (adjusting for mental health). The chances of reporting the poorer health with neighborhood problems ranged from 1.07 (95%CI: 1.03-1.11) to 2.02 (95%CI: 1.95-2.10) for the higher tertile of social disorder (physical health) and physical problem (health-related variables). Perceived neighborhood problems were independently associated with poor health. The perception of a neighborhood among its residents should be considered by health policymakers.

Association between perceived neighborhood environment and health of middle-aged women living in rapidly changing urban Mongolia

“…In this study, “citizens’ services,” a factor related to women’s general health, refers to the respondents’ perceived access to a family health center, as well as the extent of opportunities for community participation in plans and events within the neighborhood. These findings are consistent with two studies from Brazil demonstrating links between the quality of public services and better self-reported health [ 5 , 16 ]. Prioritizing the early availability of good citizens’ services in new neighborhoods may help deliver better self-reported general health for their residents.…”

Physical Disorders and Poor Self-Rated Health in Adults Living in Four Latin American Cities: A Multilevel Approach

“…These findings are in agreement with studies in countries of the global North and other countries in Latin America that showed an association between perceived physical disorder and self-rated health [12,[28][29][30][31]. Poortinga and colleagues found that urban environment characteristics, such as litter and rubbish; vandalism; and discarded needles and syringes, had the strongest associations with poor health at the neighborhood level in Wales, United Kingdom [28].…”

“…Poortinga and colleagues found that urban environment characteristics, such as litter and rubbish; vandalism; and discarded needles and syringes, had the strongest associations with poor health at the neighborhood level in Wales, United Kingdom [28]. In Brazil, researchers observed that perceived physical disorder, such as garbage; presence of graffiti; vacant lots; vandalism; street lighting, were also associated with poor self-rated health [12,31].…”

“…We then used multilevel models to estimate the area level measurement properties of the scales and to derive empirical Bayes estimates of values for each area by combining the responses of all respondents in the same area [12,24,25]. In the model, level 1 corresponded to item responses within individuals; level 2 corresponded to individuals nested within areas; and level 3 corresponded to the area.…”

“…Urban environment features may affect health through a multiplicity of processes including influencing health-related behaviors through features such as walkability, the location of parks and green spaces, and access to and advertising for different types of foods. Other•mechanisms may include community stressors such as violence or lack of safety and the availability of social connections and social support mechanisms [10][11][12][13][14][15][16].…”