The Urban Built Environment and Associations with Women’s Psychosocial Health

Abstract

The determinants that underlie a healthy or unhealthy pregnancy are complex and not well understood. We assess the relationship between the built environment and maternal psychosocial status using directly observed residential neighborhood characteristics (housing damage, property disorder, tenure status, vacancy, security measures, violent crime, and nuisances) and a wide range of psychosocial attributes (interpersonal support evaluation list, self-efficacy, John Henryism active coping, negative partner support, Perceived Stress Scale, perceived racism, Center for Epidemiologic Studies-Depression) on a pregnant cohort of women living in the urban core of Durham, NC, USA. We found some associations between built environment characteristic and psychosocial health varied by exposure categorization approach, while others (residence in environments with more rental property is associated with higher reported active coping and negative partner support) were consistent across exposure categorizations. This study outlines specific neighborhood characteristics that are modifiable risk markers and therefore important targets for increased research and public health intervention.

Small and large size for gestational age and neighborhood deprivation measured within increasing proximity to homes

“…Neighborhood deprivation may induce psychosocial stress (Messer, et al, 2012a; Culhane and Elo, 2005), which can restrict fetal growth and development through unhealthy coping behaviors (Vinikoor-Imler, et al, 2011; Elo, et al, 2009; Metcalfe, et al, 2011; Messer, et al, 2012a) or increase susceptibility to infection (Wadhwa, et al, 2011; Culhane, et al, 2001; Lu and Halfon, 2003). We found weaker associations with SGA than LGA and NDI.…”

“…That is, we theorize effects on LGA to operate through neighborhood environments that promote obesity-related behaviors (Diez Roux and Mair, 2010; Schempf, et al, 2009; Daniel, et al, 2008; Culhane and Elo, 2005; Vinikoor-Imler, et al, 2011; Elo, et al, 2009; Metcalfe, et al, 2011). Behavioral pathways leading to LGA may involve smaller-scale neighborhood features than neighborhood effects on SGA, which are theorized to operate through stress pathways (Wadhwa, et al, 2011; Culhane and Elo, 2005; Vinikoor-Imler, et al, 2011; Elo, et al, 2009; Metcalfe, et al, 2011; Messer, et al, 2012a). …”

Environmental vegetation : a possible association with cardiovascular disease risk.

“…54 The built environment is known to play a large role in influencing CVD risk factors such as physical activity, obesity, social interaction, transportation, access, stress, mental health, and pollution exposure. [1][2][3][4][5][6][7] These effects appear to play a role in both acute and chronic health conditions including CVD, cancers, respiratory diseases, and unintentional injury. 3,55 Attributes of the built environment influencing CVD and obesity are of key concern.…”

“…38 Environmental factors have been shown to modify important risk factors, affecting established risks such as exercise, stress, mental health, and accessibility. [1][2][3][4][5][6][7] The built environment has also been shown to directly affect health through increased concentrations of harmful air pollutants such as particulates, ozone, and VOCs -all of which are known to adversely affect cardiovascular health. 10,58,67,70,84 Among the many effects of the built environment on cardiovascular health, recent evidence has linked CVD with various metrics of proximate greenness in diverse locations.…”

“…[1][2][3][4][5][6][7][8][9] Impacts of natural, built, and social environments on health are known to be moderated by a multitude of characteristics of urban environments, as well as individual choices and interactions. [1][2][3][4][5][6][7][10][11][12] CVD is a non-infectious disease of the circulatory system. 13 It has been shown to be particularly sensitive to a wide variety of environmental influences on health.…”