Financial strain, neighborhood cohesion, and health-related quality of life among rural and urban Spanish-speaking Latina breast cancer survivors

PURPOSE

Among Latina breast cancer survivors, explore associations between rural/urban residence and health-related quality of life (HRQL), and whether associations are moderated by financial strain and low neighborhood cohesion.

METHODS

We combined baseline data from two randomized controlled trials of a stress management intervention conducted among 151 urban and 153 rural dwelling Latinas with nonmetastatic breast cancer. Generalized linear models estimated associations between rural/urban status and HRQL (overall, emotional, social-family, physical, and functional well-being), and we examined moderation effects of financial strain and low neighborhood cohesion, controlling for age, marital status, and breast cancer characteristics.

RESULTS

Rural women reported better emotional (β = 1.85; 95% CI = 0.37, 3.33), functional (β = 2.23; 95% CI = 0.69, 3.77), and overall (β = 5.68; 95% CI = 1.12, 10.25) well-being than urban women, regardless of degree of financial strain or neighborhood cohesion; moderation effects were not statistically significant. Financial strain was inversely associated with emotional (β = -2.34; 95% CI = 3.63, -1.05), physical (β = -2.56; 95% CI = -4.12, -1.01), functional (β = -1.61; 95% CI = -2.96, -0.26), and overall (β = -6.67; 95% CI = -10.96, -2.98) well-being. Low neighborhood cohesion was inversely associated with emotional (β = -1.27; 95% CI = -2.50, -0.04), social-family (β = -1.72; 95% CI = -3.02, -0.42), functional (β = -1.63; 95% CI = -2.92, -0.34), and overall (β = -5.95; 95% CI = 9.76, -2.14) well-being.

CONCLUSIONS

Rural Latina breast cancer survivors reported better emotional, functional and overall well-being than their urban counterparts. Greater financial strain and less neighborhood cohesion were associated with worse HRQL on most domains regardless of rural/urban context.

IMPLICATIONS FOR CANCER SURVIVORS

Interventions that focus on increasing perceived neighborhood cohesion and reducing or better managing financial strain, could help improve Latina cancer survivors' well-being.

Social security expansion and neighborhood cohesion: Evidence from community-living older adults in China

Grants and services provided by the government may crowd out informal arrangements, thus weakening informal caring relations and networks. In this paper, we examine the impact of social security expansion on neighborhood cohesion of elders using China's New Rural Pension Scheme (NRPS), one of the largest existing pension program in the world. Since its launch in 2009, more than 400 million Chinese have enrolled in NRPS. We use two waves of China Health and Retirement Longitudinal Study (CHARLS) to examine the effect of pension receipt on two dimensions of neighborhood cohesion among older adults, i.e. participation in collective recreational activities (e.g., socializing and organizational activities) and altruistic activities (e.g., helping those in need in the community), and the frequencies of these activities. Employing an instrumental variable approach, our empirical strategy addresses the endogeneity of pension receipt via exploiting geographic variation in pension program roll-out. We find evidence that receiving pension only slightly reduces collective recreational activities while significantly crowding out altruistic activities in the communities.

Trajectories of maternal aggression in early childhood: Associations with parenting stress, family resources, and neighborhood cohesion

BACKGROUND

The effects of family risk on parenting can be ameliorated or exacerbated depending on factors internal (e.g., appraisals, regulation) and external (e.g., resources, social support) to the role of parenting. Therefore, it is important to distinguish between sources of stress when exploring associations with parenting behaviors.

OBJECTIVE

We aimed to identify trajectories of maternal aggression among families across various levels of risk, and explore associations with factors internal and external to parenting.

PARTICIPANTS AND SETTING

Participants included children in large U.S. cities born between 1998 and 2000, followed through age 9, in the Fragile Families and Child Well-being Study with medical records data available (N = 3529).

METHOD

Latent growth curve modeling was conducted to identify trajectories of maternal aggression measured through a survey at child age 3, 5, and 9. Correlates of maternal aggression (i.e., family risk for maltreatment, income-to-poverty ratios, maternal education, parenting stress, and neighborhood cohesion) were measured through medical records and maternal surveys at birth, age 1, and age 3.

RESULTS

Maternal aggression similarly declined between child age 3 and 9 across low-, moderate-, and high-risk families. Across all families, neighborhood social cohesion was significantly, negatively associated with maternal aggression, (β's = -.20 to -.28, p's < .001) and increases in parenting stress were significant predictors among Low Risk (β = .12, p = .006) and High Risk (β = .10, p = .02) families.

CONCLUSION

The results suggest that families could benefit from supportive neighborhood environments or parenting stress reduction techniques, regardless of level of risk at birth.

Social capital in the creation of cultural capital: Family structure, neighborhood cohesion, and extracurricular participation

Past research has found that participation in extracurricular activities helps develop children's cultural capital that is crucial to both education and career successes. Previous studies have examined various determinants of extracurricular participation, but mostly focused on social class, demographics, and school characteristics. In this paper we renew the Coleman tradition by putting social capital (as measured by family structure and neighborhood cohesion) in the spotlight and studying the effect of social capital on youth participation in organized extracurricular activities. By using longitudinal data from the 2004 panel of the Survey of Income and Program Participation of representative households in the U.S. and conducting various robust statistical analyses, we provide updated results on the subject. We find that a two-parent household (especially in relative to households with cohabiting parents) and neighborhood cohesion (i.e., a set of cohesive relationships among parents in the neighborhood) both have a positive and significant association with extracurricular participation. We also find such associations vary somewhat by child's sex, age, race, and the type of extracurricular activity. We conclude that to equalize children's participation in extracurricular activities future social policies should consider interventions that target low-income families and families with single-parent or cohabiting parents, that can improve neighborhood cohesion, and that are tailored by the type of extracurricular activity.

Differences by Sexual Orientation in Perceptions of Neighborhood Cohesion: Implications for Health

A large body of research documents the relationship between health and place, including the positive association between neighborhood cohesion and health. However, very little research has examined neighborhood cohesion by sexual orientation. This paper addresses that gap by examining differences in perceived neighborhood cohesion by sexual orientation. We use data from the 2016 National Health Interview Survey (n = 28,164 respondents aged 18 years and older) to examine bivariate differences by sexual orientation in four measures of neighborhood cohesion. We then use ordered logistic regression models to assess the relationship between sexual orientation and a scaled measure of neighborhood cohesion, adjusting for socio-demographic characteristics, living arrangements, health status, region, and neighborhood tenure. We find that lesbian, gay, and bisexual (LGB) adults are less likely to say that they live in a close-knit neighborhood (54.6 vs. 65.6%, p < 0.001), they can count on their neighbors (74.7 vs. 83.1%, p < 0.001), they trust their neighbors (75.5 vs. 83.7%, p < 0.001), or people in their neighborhood help each other out (72.9 vs. 83.1%, p < 0.001), compared to heterosexual adults. Even after controlling for socio-demographic factors, neighborhood cohesion scores are lower for LGB adults compared to heterosexual adults (odds ratio of better perceived neighborhood cohesion for sexual minorities: 0.70, p < 0.001). Overall, LGB adults report worse neighborhood cohesion across multiple measures, even after adjusting for individual characteristics and neighborhood tenure. Because living in a cohesive neighborhood is associated with better health outcomes, future research, community-level initiatives, and public policy efforts should focus on creating welcoming neighborhood environments for sexual minorities.

Relations among Perceptions of Neighborhood Cohesion and Control and Parental Monitoring across Adolescence

Social disorganization theory argues that disadvantaged neighborhoods will have less cohesion and control, and therefore will be less conducive to effective parental monitoring. This study aims to test these relationships using four waves of the Pitt Mother and Child Project (ages 11, 12, 15, and 17). The sample consists of 185 low-income males and their parents, 56.44% of whom identify as White, and 34.67% of whom identify African American. Crossed-lagged path models were estimated and the indirect effect of neighborhood disadvantage on parental monitoring through neighborhood cohesion and control was estimated. Separate models were estimated for parental and adolescent perceptions of parental monitoring. The results demonstrate a positive relationship between parental perception of neighborhood social cohesion and parental monitoring, and a negative relationship found between parental perceptions of neighborhood social control and parental monitoring in both models. The findings of this study suggests that neighborhoods may be an important target for interventions that are aiming to improve parental monitoring and ultimately adolescent outcomes.

Out Drinking the Joneses: Neighborhood Factors Moderating the Effects of Drinking on Relationship Quality over the First Four Years of Marriage

Neighborhood quality has been cross-sectionally linked to both relationship behaviors and relationship well-being. Consistent with the Vulnerability Stress-Adaptation model of relationship functioning (Karney & Bradbury, 1995), we hypothesized that associations between social behaviors (e.g., drinking) and relationship quality could be moderated by neighborhood factors. Specifically, we characterized neighborhoods along multiple dimensions using multiple methods (self-report, census) to investigate how neighborhood factors might clarify ambiguous effects of alcohol use on marital functioning. A nationally recruited sample of 303 newlywed couples completed a baseline assessment around the time of marriage and was then assessed yearly across the first 4 years of marriage (94% retention). Three level HLM slope-intercept models were used to model changes in relationship satisfaction across the first 4 years of marriage. Results suggested that, for couples living in highly disordered neighborhoods, positive shifts in overall levels of drinking within specific waves of assessment were associated with corresponding negative shifts in satisfaction whereas in neighborhoods without perceived disorder, this effect was reversed. For couples living in neighborhoods with low levels of domestic structures (high census rates of single renters without children), within-couple discrepancies favoring higher rates of husband drinking in specific waves predicted poorer relationship quality for both partners in those same waves whereas those same discrepancies predicted higher satisfaction in high domesticity neighborhoods (high census rates of married homeowners with children). The findings provide insight into the different roles of alcohol use in relationship maintenance and highlight the importance of using external context to understand intradyadic processes.

Linking profiles of neighborhood elements to health and related outcomes among children across the United States

The current study explored association of neighborhood elements to children's health and related outcomes. Nationally representative data (N = 49,513,974, ages 6-17, 51.1% Male) was used to empirically define classes of neighborhoods based on presence or absence of various neighborhood elements. Analyses resulted in a three-class model: 1) "High Assets, Low Disorganization" (64.57%), 2) "High Assets, High Disorganization" (13.51%), and 3) "Few Assets, Low Disorganization" (21.91%). Class Membership was differentially associated with health, flourishing, and neighborhood cohesion. Results suggest health interventions should focus on increasing neighborhood assets, decreasing levels of neighborhood violence and poverty, and improving social dynamics of neighborhoods.

Association Between Neighborhood Cohesion and Cancer Screening Utilization in Chinese American Older Adults

This study aims to examine the association between neighborhood cohesion and cancer screening utilization in a community-dwelling Chinese American older population. Data were drawn from the Population Study of Chinese Elderly including 3159 Chinese American older adults aged 60 and above in the greater Chicago area. Cancer screening utilization was assessed by asking whether participants had undergone colon, breast, cervical, or prostate cancer screening. Neighborhood cohesion was measured through six questions. Logistic regression analysis showed that greater neighborhood cohesion was associated with higher likelihood of utilizing a mammogram (OR 1.32, 95% CI 1.14-1.52), a Pap test (OR 1.22, 95% CI 1.06-1.41), but not of a blood stool test (OR 1.10, 95% CI 0.98-1.23), a colonoscopy (OR 1.05, 95% CI 0.94-1.17), and a PSA test (OR 1.13, 95% CI 0.95-1.34). This study suggests positive associations between neighborhood cohesion and breast and cervical cancer screening utilization among a Chinese American older population.

Perceptions as the crucial link? The mediating role of neighborhood perceptions in the relationship between the neighborhood context and neighborhood cohesion

This study examines the effects of neighborhood racial in-group size, economic deprivation and the prevalence of crime on neighborhood cohesion among U.S. whites. We explore to what extent residents' perceptions of their neighborhood mediate these macro-micro relationships. We use a recent individual-level data set, the American Social Fabric Study (2012/2013), enriched with contextual-level data from the U.S. Census Bureau (2010) and employ multi-level structural equation models. We show that the racial in-group size is positively related to neighborhood cohesion and that neighborhood cohesion is lower in communities with a high crime rate. Individuals' perceptions of the racial in-group size partly mediate the relationship between the objective racial in-group size and neighborhood cohesion. Residents' perceptions of unsafety from crime also appear to be a mediating factor, not only for the objective crime rate but also for the objective racial in-group size. This is in line with our idea that racial stereotypes link racial minorities to crime whereby neighborhoods with a large non-white population are perceived to be more unsafe. Residents of the same neighborhood differ in how they perceive the degree of economic decay of the neighborhood and this causes them to evaluate neighborhood cohesion differently, however perceptions of neighborhood economic decay do not explain the link between the objective neighborhood context and neighborhood cohesion.

Using Walk Score™ and Neighborhood Perceptions to Assess Walking Among Middle-Aged and Older Adults

We aimed to determine the relationship between neighborhood characteristics (walkability, cohesion/safety) and recommended activity levels among community-dwelling middle-aged and older adults. Subjective and objective data on 394 individuals aged ≥50 years were used to assess the likelihood of walking ≥150 min/week. Environmental factors associated with a greater likelihood of any walking ≥150 min/week included living in a neighborhood with high perception of cohesion/safety versus low, living in walkable areas versus car-dependent, and living in an area with a low-moderate median income versus the lowest. Middle-aged and older adults were more likely to walk ≥150 min/week in a walkable, perceived safe/cohesive neighborhood. Identifying neighborhood factors associated with promoting walking among this population can enable stakeholders (e.g., researchers, planners, and policy makers) to direct interventions focusing on the built environment.

The Associations and Correlations Between Self-reported Health and Neighborhood Cohesion and Disorder in a Community-dwelling U.S. Chinese Population

Purpose of the Study

Characteristics of neighborhood have been found to be associated with physical and psychological health status of older adults, especially in relationship to social dynamics like cohesion and disorder. This study aims to examine correlations and associations between sociodemographic characteristics, self-reported health status, cohesion, and disorder among Chinese older adults in the greater Chicago area.

Design and Methods

The Population Study of Chinese Elderly in Chicago is a cross-sectional, population-based study with community-dwelling Chinese older adults aged 60 and older, recruited through a community-based participatory research approach. Cohesion was measured through six questions; disorder was measured through eight questions. Correlation and regression analyses were conducted using SAS.

Results

Among 3,158 participants enrolled in the study, 92.3% reported any neighborhood cohesion; 69.8% reported any neighborhood disorder. After controlling for age, sex, education, income, marital status, living arrangement, number of children, years in the community, years in the United States, country of origin, language preference, and location, a higher level of cohesion is associated with higher quality of life (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.13, 1.39) and a higher level of disorder is associated with lower overall health status (OR: 0.97, 95% CI: 0.95, 0.99) and lower quality of life (OR: 0.96, 95% CI: 0.95, 0.98).

Implications

Our findings suggest that neighborhood cohesion and neighborhood disorder are correlated to the health of U.S. Chinese older adults. Future longitudinal research should examine the relationship between community characteristics, both structural and social, and health-related outcomes.

Individual factors, neighborhood social context and asthma at age 5 years

OBJECTIVE

Childhood asthma is a major public health problem and its development is multifactorial. We examined whether neighborhood cohesion and disorder were associated with caregiver-report of asthma at age 5 years.

METHODS

This study is a secondary data analysis of the 2011-2012 United States National Survey of Children's Health. Data were available for 4680 children, age 5 years old born at term or preterm with birthweight >2500 g. Neighborhood disorder and cohesion were assessed based on caregivers' responses to validated questionnaires. Child asthma diagnosis was reported by the caregiver. Multivariable logistic regression was used to examine the relationship between these neighborhood factors and caregiver-report of child asthma, while accounting for individual level covariates.

RESULTS

Approximately two-thirds of the 4680 children were White and lived in households with income >400% of federal poverty line. Asthma was present in 399 (9%) children. Child female sex was associated with reduced risk of caregiver-reported asthma while non-Hispanic Black race and having smokers in the household were independently associated with increased risk in multivariable models. In these models, neighborhood disorder was significantly associated with asthma (adjusted Odds Ratio [aOR] 1.70, 95% Confidence Interval [CI] 1.04-2.78), while neighborhood cohesion was not (aOR 0.93, 95% CI 0.51-1.68).

CONCLUSION

Even after adjustment for several individual level factors, neighborhood disorder was associated with caregiver-report of asthma in this nationally representative sample of 5-year-old children. Further research is needed to better understand how risk factors at different levels of the socio-ecological framework may interact to affect childhood asthma development.

Social capital and vulnerable urban youth in five global cities

PURPOSE

Social capital is essential for the successful development of young people. The current study examines direct measures of social capital in young people in five urban global contexts.

METHODS

The Well-Being of Adolescents in Vulnerable Environments is a global study of young people aged 15-19 years living in disadvantaged, urban settings. Respondent-driven sampling was used to recruit approximately 500 participants from each site. The sample included 2,339 young people (mean age 16.7 years; 47.5% female). We examined the associations between social capital in four domains-family, school, peers, and neighborhood and demographic characteristics-using gender-stratified ordinary least-squares regression. We also examined associations between self-reported health and the four social capital domains, which was minimal.

RESULTS

School enrollment was positively associated with social capital for young women in Baltimore, Delhi, and Shanghai; the association was less consistent for young men. The same pattern is true for perceived wealth. Unstable housing was associated with low familial social capital in all groups except young women in Shanghai and young men in Ibadan and Johannesburg. Being raised outside a two-parent family has a widespread, negative association with social capital. Self-reported health had a mainly positive association with social capital with the most consistent association being neighborhood social capital.

CONCLUSIONS

Different types of social capital interact with social contexts and gender differently. Strategies that aim to build social capital as part of risk reduction and positive youth development programming need to recognize that social capital enhancement may work differently for different groups and in different settings.

Neighborhood cohesion and daily well-being: results from a diary study

Neighborly cohesiveness has documented benefits for health. Furthermore, high perceived neighborhood cohesion offsets the adverse health effects of neighborhood socioeconomic adversity. One potential way neighborhood cohesion influences health is through daily stress processes. The current study uses participants (n = 2022, age 30-84 years) from The Midlife in the United States II and the National Study of Daily Experiences II, collected between 2004 and 2006, to examine this hypothesis using a within-person, daily diary design. We predicted that people who perceive high neighborhood cohesion are exposed to fewer daily stressors, such as interpersonal arguments, lower daily physical symptoms and negative affect, and higher daily positive affect. We also hypothesized that perceptions of neighborhood cohesion buffer decline in affective and physical well-being on days when daily stressors do occur. Results indicate that higher perceived neighborhood cohesion predicts fewer self-reported daily stressors, higher positive affect, lower negative affect, and fewer physical health symptoms. High perceived neighborhood cohesion also buffers the effects of daily stressors on negative affect, even after adjusting for other sources of social support. Results from the present study suggest interventions focusing on neighborhood cohesion may result in improved well-being and may minimize the adverse effect of daily stressors.