Neighborhood social environments, healthy resources, and adult diabetes: Accounting for activity space exposures

The four stages of neighborhood trust: Classic grounded theory

INTRODUCTION

Neighborhoods are often overlooked as a determinant of health. Among recent research, the focus on "place-based effects," due to prolonged residential environmental exposure, has been of particular interest. These studies' purpose is to identify and examine how a healthy neighborhood is intentionally created to describe a transferable process-driven theory.

METHOD

A classic grounded theory approach was used in these studies. Data sources include individual in-depth interviews, historical documents, and a member-checking focus group, collected over 3-years.

RESULTS

Analysis generated the Four Stages of Neighborhood Trust Model, which is nested within the context of perceived neighborhood safety. The theory outlines a social process of four stages of neighborhood trust: (a) rules-based agreements, (b) shared values, (c) cooperation, and (d) neighborhood belonging.

CONCLUSIONS

We present the development of a process-driven theory that may be useful for public health nurses as they engage neighborhoods in health promotion activities. The stage of trust development will aid the nurse in identifying what is needed to move to the next stage in a healthy neighborhood process.

Neighborhood social organization exposures and racial/ethnic disparities in hypertension risk in Los Angeles

Despite a growing evidence base documenting associations between neighborhood characteristics and the risk of developing high blood pressure, little work has established the role played by neighborhood social organization exposures in racial/ethnic disparities in hypertension risk. There is also ambiguity around prior estimates of neighborhood effects on hypertension prevalence, given the lack of attention paid to individuals' exposures to both residential and nonresidential spaces. This study contributes to the neighborhoods and hypertension literature by using novel longitudinal data from the Los Angeles Family and Neighborhood Survey to construct exposure-weighted measures of neighborhood social organization characteristics-organizational participation and collective efficacy-and examine their associations with hypertension risk, as well as their relative contributions to racial/ethnic differences in hypertension. We also assess whether the hypertension effects of neighborhood social organization vary across our sample of Black, Latino, and White adults. Results from random effects logistic regression models indicate that adults living in neighborhoods where people are highly active in informal and formal organizations have a lower probability of being hypertensive. This protective effect of exposure to neighborhood organizational participation is also significantly stronger for Black adults than Latino and White adults, such that, at high levels of neighborhood organizational participation, the observed Black-White and Black-Latino hypertension differences are substantially reduced to nonsignificance. Nonlinear decomposition results also indicate that almost one-fifth of the Black-White hypertension gap can be explained by differential exposures to neighborhood social organization.

Racial Inequalities in Adolescents' Exposure to Racial and Socioeconomic Segregation, Collective Efficacy, and Violence

In the United States, Black youth tend to grow up in remarkably less resourced neighborhoods than White youth. This study investigates whether and to what extent Black youth are moreover exposed to less resourced activity spaces beyond the home. We draw on GPS data from a large sample of urban youth in the Columbus, Ohio-based Adolescent Health and Development in Context study (2014-2016) to examine to what extent Black youth experience nontrivial, disproportionate levels of exposure to more disadvantaged and segregated contexts in their daily routines compared with similarly residentially situated White youth. Specifically, we estimate Black-White differences in nonhome exposure to concentrated disadvantage, racial segregation, collective efficacy, and violent crime. We find that Black youths' activity spaces have substantially higher rates of racial segregation and violent crime than those of White youth, and substantially lower levels of collective efficacy-even after accounting for a host of individual- and home neighborhood-level characteristics. We find more modest evidence of differences in exposure to socioeconomic disadvantage. These findings have important implications for neighborhood-centered interventions focused on youth well-being and the contextual effects and segregation literatures more generally.

Assessing Measurement Invariance of a Land Use Environment Construct Across Levels of Urbanicity

Variation in the land use environment (LUE) impacts the continuum of walkability to car dependency, which has been shown to have effects on health outcomes. Existing objective measures of the LUE do not consider whether the measurement of the construct varies across different types of communities along the rural/urban spectrum. To help meet the goals of the Diabetes Location, Environmental Attributes, and Disparities (LEAD) Network, we developed a national, census tract-level LUE measure which evaluates the road network and land development. We tested for measurement invariance by LEAD community type (higher density urban, lower density urban, suburban/small town, and rural) using multiple group confirmatory factor analysis. We determined that metric invariance does not exist; thus, measurement of the LUE does vary across community type with average block length, average block size, and percent developed land driving most shared variability in rural tracts and with intersection density, street connectivity, household density, and commercial establishment density driving most shared variability in higher density urban tracts. As a result, epidemiologic studies need to consider community type when assessing the LUE to minimize place-based confounding.

Community social environments and cigarette smoking

Cigarette smoking remains a primary contributor to health disparities in the United States, and significant evidence suggests that smoking behavior is socially influenced. Though residential neighborhoods are important for health disparities, recent evidence suggests that people spend the majority of their waking time away from the residential neighborhood. We advance research on neighborhoods and smoking by using individual, neighborhood, and activity space data for adults in the Los Angeles Family and Neighborhood Survey (L.A.FANS). Moving beyond socioeconomic indicators of neighborhoods, we investigate the ways in which residential neighborhood social cohesion, neighborly exchange, and perceived danger impact smoking behavior after accounting for confounding factors in both the residential neighborhood and other activity spaces in which adults spend their days. We find that perceptions of danger in the residential neighborhood is robustly associated with the likelihood of smoking cigarettes. Further, measures of community social organization interact with perceived danger to influence smoking behavior. Adults with high levels of perceived danger are twice as likely to smoke if residing in communities with lower levels of social organization in the form of helpful, trusting, and supportive relationships. Understanding how the social organization of communities contributes to smoking disparities is important for curbing smoking's impact on population health.

Environmental inequity in hilly neighborhood using multi-source data from a health promotion view

The study focused on the justice of residents' opportunity to engage in healthy behavior under different environments is not vast, especially in a hilly dwelling environment. Therefore, this paper investigates environmental inequalities in a hilly urban environment in the context of the booming real estate market in China, comprised of health promotion-related elements, namely, built environment, physical activity facilities, street infrastructure, green spaces, and environmental perceptions. The multi-source data are used to calculate environmental attributes and the socioeconomic status of communities. We take the central districts of Dalian city as the research area and measure environmental equity across different socioeconomic residential areas using the Kruskal-Wallis one-way analysis of variance. The results reveal the spatial disparities in physical activity facilities, street greening, and positive perceptions between different communities. However, green injustice is mitigated in the hilly neighborhoods when we consider only ground-level greenness. This paper studies environmental justice by taking a health-enhancing view, and the results of this study can provide guidance on hilly urban development for government leaders and planners.