Do Religious Struggles Mediate the Association Between Neighborhood Disorder and Health in the United States?

Over the past two decades, numerous studies have linked the subjective experience of neighborhood disorder (perceptions of crime, dilapidation and ambient strains) with poorer health. We test whether religious struggles (religious doubts and feeling abandoned or punished by God) mediate this association. Our counterfactual mediation analyses of data from the 2021 Crime, Health, and Politics Survey (CHAPS) (n = 1741) revealed consistent indirect effects of neighborhood disorder through religious struggles for anger, psychological distress, sleep disturbance, poorer self-rated health, and shorter subjective life expectancy. This study contributes to previous work by integrating the study of neighborhood context and religion.

Residential Segregation, Perceived Neighborhood Environment, and All-Cause Mortality Among Community-Dwelling Older Chinese Americans

OBJECTIVES

Residential segregation profoundly affects mental and physical health. However, impacts of residential segregation and other neighborhood characteristics on health among older Asian Americans are not fully understood. This study aimed to close this gap by examining effects of residential segregation, perceived neighborhood cohesion, and neighborhood disorder on all-cause mortality among older Chinese immigrants, as well as testing whether the association between residential segregation and mortality would be mediated by perceived neighborhood cohesion and neighborhood disorder.

METHODS

Data were drawn from a subsample of 3,094 older Chinese Americans aged 60 and older (mean age = 72.8 years) from the Population Study of Chinese Elderly in Chicago. Residential segregation was derived using 2010-2014 American Community Survey data. Participants completed surveys on perceived neighborhood cohesion and neighborhood disorder between 2011 and 2013. All-cause mortality was tracked until December 2021.

RESULTS

Residential segregation was associated with elevated all-cause mortality risk; this association, however, was no longer statistically significant after controlling for sociodemographic, behavioral, and health covariates. Perceived neighborhood cohesion, but not neighborhood disorder, was significantly associated with decreased mortality risks. There were no indirect effects of residential segregation on all-cause mortality through perceived neighborhood cohesion or neighborhood disorder. These effects were consistent across male and female participants.

DISCUSSION

These results suggest the importance of neighborhood social environment, specifically perceptions of neighborhood cohesion, in influencing mortality risk among older Chinese immigrants. The findings also indicate the need to conduct further research to examine the health impact of residential segregation among this population.

An examination of the relationships between the neighborhood social environment, adiposity, and cardiometabolic disease risk in adolescence: a cross-sectional study

BACKGROUND

Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years.

METHODS

This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey five-year block group estimates, 2012-2016. Multilevel linear regression models were used to examine whether neighborhood concentrated disadvantage index and perceived neighborhood disorder were associated with body mass index, waist circumference, body fat, adipose tissue, blood pressure, and lipids. We performed multilevel logistic regression to determine the odds of elevated adiposity and cardiometabolic disease risk for adolescents living in neighborhoods with varying levels of neighborhood concentrated disadvantage and disorder.

RESULTS

Adolescents living in neighborhoods with higher disadvantage or disorder had greater waist circumference and total percent body fat compared to those in less disadvantaged and disordered neighborhoods (p for trend < 0.05). Neighborhood disadvantage was also positively associated with percentage of the 95th Body Mass Index percentile and visceral abdominal adipose tissue mass while greater perceived neighborhood disorder was related to higher trunk fat mass and diastolic blood pressure (p for trend < 0.05). Living in the most disadvantaged was associated with greater odds of obesity (OR: 2.9, 95% CI:1.3, 6.5) and being in the top tertile of body fat mass (OR: 3.0, 95% CI: 1.4, 6.6). Similar results were found with neighborhood disorder for odds of obesity (OR: 2.1, 95% CI:1.1, 4.2) and top tertile of body fat mass (OR: 2.1, 95% CI:1.04, 4.1).

CONCLUSIONS

Neighborhood social environment measures of chronic stress exposure were associated with excess adiposity during adolescence, and relationships were most consistently identified among adolescents living in the most disadvantaged and disordered neighborhoods. Future studies should account for the influences of the neighborhood environment to stimulate equitable improvements in adolescent health. CLINICAL TRIALS REGISTRATION: # NCT02784509.

Perceived neighborhood disorder as a moderator of the relationship between marijuana use and disinhibition in a sample of emerging adult African American females

Disinhibition is associated with myriad risk-taking behaviors and adverse outcomes. Both marijuana use and poor neighborhood conditions have been associated with disinhibition. However, the extent to which neighborhood disorder interacts with marijuana use to influence disinhibition has not been studied, extensively. A better understanding of these relationships has implications for designing more effective tailored place-based interventions that aim to reduce risk taking behaviors and related adverse social and health outcomes associated with marijuana use. Thus, the purpose of this study was to examine the interactive effects of perceived neighborhood disorder and marijuana use on disinhibition. The sample included 120 African American female residents of disadvantaged neighborhoods (Mage = 23.6 ± 3.46). We employed hierarchical linear regression analysis to examine the interactive effects of marijuana use and perceived neighborhood disorder on disinhibition, while controlling for age and education. The interaction term was marginally significant (b = 5.66; t(109) = 1.72, p = .08). Next, the conditional effects were explored. Results indicated the association of marijuana use with disinhibition was stronger for females in the higher neighborhood disorder group, compared to those in the lower neighborhood disorder group (10.40 and 4.51, respectively). Our findings support the need for more research on the potential of neighborhood disorder to amplify the effects of marijuana use on disinhibition and related neurobehavioral traits. The identification of contextual moderators and high-risk sub-groups will aid in the design of more tailored place-based interventions that aim to reduce risk-taking behavior among those most vulnerable.

Neighborhood Cohesion, Perceptions of Disorder, and the Geography of Women's Fear of Crime in Informal Settlements in Nairobi, Kenya

Fear of crime is more pervasive and harder to address than crime itself and can cause physical and psychological health complications, particularly for women. Fear of crime is not always grounded in direct exposure to crime. Instead, it may be more directly linked to social cohesion and/or perceptions of neighborhood disorder, but little is known about these associations in informal settlements. This paper sought to explore these relationships in Mathare-a large informal settlement in Nairobi, Kenya. Using responses from surveys with 550 women in Mathare, we conducted regression, mediation, and moderated mediation analyses to investigate relationships between neighborhood disorder, fear of crime, and neighborhood cohesion and explore how these associations vary across geographic spaces (villages). Findings suggest that women's perceptions of neighborhood disorder are associated with fear of crime; neighborhood cohesion partially mediates the relationship between perceptions of neighborhood disorder and fear of crime; women's fear of crime varies by village; and the mediating role of neighborhood cohesion also varies by village. Efforts to build and strengthen social cohesion in informal settlements may help to reduce women's fear of crime, but more research is needed to explore under what conditions and in what spaces interventions are the most effective.

Racial Differences in the Relationship between Neighborhood Disorder, Adverse Childhood Experiences, and Child Behavioral Health

The neighborhood and family context in which children grow profoundly influences their development. Informed by ecological systems theory and social disorganization theory, we hypothesized that adverse childhood experiences (ACEs) mediate the relationship between neighborhood disorder and child externalizing and internalizing behaviors, and that these pathways vary by race/ethnicity. We conducted secondary data analysis using Fragile Families and Child Well-being study data. To test hypothesized pathways, we performed a mediation path analysis on a sample of 3001 mothers of children (ages 3 and 5) living in 20 U.S. cities. A moderated mediation path analysis was used to test racial/ethnic differences in hypothesized pathways. We found that living in disordered neighborhoods increased children's likelihood of exhibiting externalizing and internalizing behaviors through childhood ACEs. Compared to Black and Hispanic children, White children's ACEs were more susceptible to negative neighborhood environment effects, suggesting that White children's behavioral health may be more indirectly affected by neighborhood disorder. The finding that ACEs mediated the pathway from neighborhood disorder to child behavior problems provides opportunity for child psychiatrists and pediatricians to interrupt negative pathways by providing interventions for children and families. Our findings on racial/ethnic differences highlight the need for culturally sensitive programming to address children's behavior problems.

Pathways linking census tract typologies with subjective neighborhood disorder and depressive symptoms in the Black Women's Experiences Living with Lupus (BeWELL) Study

Depression is a common comorbidity among Black women with systemic lupus erythematosus (SLE), an understudied autoimmune disease characterized by major racial and gender inequities. Research is needed that examines how area-level factors influence risk of depression in this population. Latent profile analysis revealed four neighborhood typologies among metropolitan Atlanta, Georgia census tracts that participants (n=438) in the Black Women's Experiences Living with Lupus (BeWELL) Study were living in: Integrated/High-SES, Moderately Segregated/Mid-SES, Highly Segregated/Mid-SES, and Highly Segregated/Low-SES. Structural equation models indicated that highly segregated census tracts were associated with the greatest levels of depression via increased subjective assessments of neighborhood disorder. Policies that invest in segregated areas and address physical and social aspects of the environment that contribute to neighborhood disorder may promote mental health among Black women with SLE.

Understanding Youth Perceptions of Neighborhood Disorder: The Role of Conduct Problems

While research addresses neighborhood disorder as leading to conduct problems, the role of individual-level differences in shaping adolescent perceptions of neighborhood has been overlooked. Data on youth, over-selected for childhood conduct problems (N = 744, 58% childhood conduct problems, 47% girls), were used to examine the link between conduct problems (time 1: Mean age = 12.23) and perceived neighborhood disorder (time 3: M = 14.30). The mediating role of delinquent friends, peer victimization, depressive symptoms, and observer-rated neighborhood disorder (time 2: M = 13.23) were also tested. Conduct problems were associated with higher levels of perceived neighborhood disorder, via delinquent peers and peer victimization. These findings offer new insight into the consequences of perceived neighborhood disorder for health and wellbeing.

Drifting Tobacco Smoke Exposure among Young Adults in Multiunit Housing

This study evaluated young adults' exposure to drifting secondhand smoke in San Francisco County housing units using the 2014 Bay Area Young Adult Health Survey (N = 1363). Logistic and geographically weighted regression models were used to determine whether residing in multiunit housing or in areas with greater neighborhood disorder were risk factors for exposure, and how drifting smoke exposure varied spatially within San Francisco County. Residing in buildings with five or more units significantly increased the odds of reporting drifting smoke exposure [OR (3.5 1.3, 9.9)], but neighborhood disorder did not have a significant association in the fully adjusted logistic regression model. At the local level, however, neighborhood disorder was significantly associated with exposure in lower income residential and downtown areas. Multiunit housing was significantly associated with exposure across all neighborhoods.

Neighborhood physical disorder and common mental disorders in adolescence

OBJECTIVE

The aim of this study is to estimate the association between observed indicators of neighborhood physical disorder and common mental disorders in adolescents.

METHODS

The study population included 2506 adolescents from three Brazilian state capitals (Rio de Janeiro, Porto Alegre, and Fortaleza) who participated in the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional school-based study conducted in 2013-2014. Common mental disorders were assessed using the 12-item General Health Questionnaire. Measures of neighborhood physical disorder were based on the 2010 Brazilian census data and were derived using principal component analysis.

RESULTS

Although associations were found between some exposure components and CMD, there were no clear or consistent trends across exposure quartiles.

CONCLUSION

Overall, there was no evidence of an association between observed indicators of neighborhood physical disorder and common mental disorders. Future studies should explore alternative tools for measuring neighborhood physical disorder to minimize the likelihood of exposure misclassification.

Associations among Early Exposure to Neighborhood Disorder, Fathers' Early Involvement, and Children's Internalizing and Externalizing Problems

PURPOSE

This study aimed to examine (1) the effects of early exposure to neighborhood disorder and fathers' early involvement on children's long-term internalizing and externalizing problems, and (2) whether fathers' early involvement buffered effects of early exposure to neighborhood disorder on children's internalizing and externalizing problems.

METHOD

We used five waves of Fragile Family and Child Wellbeing study data and conducted multi-level longitudinal mixed-effects models to examine relationships among early exposure to neighborhood disorder, fathers' early involvement, and children's internalizing and externalizing problems.

RESULTS

Results indicated that early exposure to neighborhood disorder was associated with increased children's internalizing and externalizing problems, while fathers' early involvement was associated with decreased children's internalizing and externalizing problems. However, fathers' early involvement did not buffer the negative effects of early exposure to neighborhood disorder on children's internalizing and externalizing problems.

DISCUSSION

The findings suggest the importance of neighborhood order and fathers' early involvement in decreasing children's internalizing and externalizing problems. Developing neighborhood-level interventions and improving fathers' involvement in early childhood are potential strategies to prevent children's behavioral problems in the long term.

Neighborhood disorder predicts lower serum vitamin D levels in pregnant African American women: A pilot study

Pregnant African American women are more likely to live in neighborhoods with more disorder (e.g., vacant housing, littler, crime) and to have vitamin D deficiency due to their darker skin pigmentation and poor production of vitamin D [25(OH)D] from ultraviolet rays. However, no study has examined the potential link between neighborhood disorder and 25(OH)D status in African American pregnant women. Forty-one pregnant African American women completed validated questionnaires about perceived neighborhood disorder (6 items; 3-point scale; range 6-18) and with concurrent serum levels of 25-hydroxyvitamin D [25(OH)D] assessed during pregnancy at 18-24 weeks gestation. Higher levels of perceived neighborhood disorder were associated with lower levels of serum 25(OH)D. Pregnant African American women who report higher disorder in their neighborhood may spend less time outside. Health care providers should include assessment of perceived neighborhood disorder. Future research needs to evaluate the relationships among neighborhood disorder and 25(OH)D levels among pregnant African American women.

Neighborhood disorder and child behavioral problems among kinship children: Mediated by social support and moderated by race/ethnicity?

BACKGROUND

Children in kinship care may be placed in similar neighborhoods as their birth families, which are predominantly characterized as distressed neighborhoods with high poverty and crime rates, poor-quality housing conditions, and few social resources. Disordered neighborhoods are negatively correlated to social support, but this dynamic may vary by race or ethnicity. However, children's previously established attachment and social bonding may offset the negative effects of distressed neighborhoods on child behavioral health.

OBJECTIVES

This study examined the relation between neighborhood disorder and children's internalizing and externalizing problems among children in kinship care and tested caregivers' social support as a potential mediator. Moreover, this study examined if race/ethnicity moderated the pathway from neighborhood disorder to social support, and from social support to children's internalizing and externalizing problems.

PARTICIPANTS AND SETTING

This study used NSCAW II wave 3 data for a sample of children in kinship care.

METHODS

Univariate, bivariate, and moderated mediation analyses were conducted using STATA 15.

RESULTS

Neighborhood disorder was indirectly associated with children's internalizing and externalizing problems through a mediator of social support. No racial/ethnic differences were identified.

CONCLUSIONS

Implications for improving social support for kinship caregivers to ameliorate the effects of neighborhood disorder on children's behavioral health are discussed. Implementing effective neighborhood-level interventions could promote positive outcomes for children in kinship care.

Neighborhood Disorder, Family Functioning, and Risky Sexual Behaviors in Adolescence

Adolescent risky sexual behaviors can result in negative consequences such as sexually transmitted infection. However, much research effort has been placed on understanding individual characteristics, rather than the role of neighborhood environment. This study addressed the prospective effects of neighborhood and family functioning in preadolescence on risky sexual behaviors. Participants included 4179 youth (Mage = 11.01 years, range 8.64-13.83; 51% female) and their caregivers. Using objective and self-reported measures of neighborhood and family functioning, results from multilevel regression analyses indicated that youth residing in disordered neighborhoods or had poorer family functioning in preadolescence were more likely to initiate sexual intercourse at younger ages 5 years later. Specifically, neighborhood poverty and decay were linked to early sexual initiation, whereas neighborhood social and family processes were protective against early sexual initiation. Males were more likely to engage in risky sexual behaviors in neighborhoods with greater poverty or decay; neighborhood poverty was linked with sexual initiation in White but not African American youth. Finally, parental monitoring moderated relationships between neighborhood social resources and contraceptive use, with neighborhood social resources linked with greater contraceptive use at low levels of parental monitoring, but lower contraceptive use at high levels of parental monitoring. These findings underscore the importance of neighborhood and family contexts in adolescents' risky sexual behavior, suggesting that males and White youth are more vulnerable to the effects of neighborhood poverty and that more research is needed on the possible counterproductive function of parental monitoring in neighborhoods with greater social resources.

Measuring Neighborhood Order and Disorder: a Rapid Literature Review

PURPOSE OF REVIEW

Neighborhood disorder has received attention as a determinant of health in urban contexts, through pathways that include psychosocial stress, perceived safety, and physical activity. This review provides a summary of data collection methods, descriptive terms, and specific items employed to assess neighborhood disorder/order.

RECENT FINDINGS

The proliferation of methods and terminology employed in measuring neighborhood disorder (or neighborhood order) noted over the past two decades has made related studies increasingly difficult to compare. Following a search of peer-reviewed articles published from January 1998 to May 2018, this rapid literature review identified 18 studies that described neighborhood environments, yielding 23 broad terms related to neighborhood disorder/order, and a total of 74 distinct measurable items. A majority of neighborhood disorder/order measurements were assessed using primary data collection, often relying on resident self-report or investigatory observations conducted in person or using stored images for virtual audits. Items were balanced across signs of order or disorder, and further classification was proposed based on whether items were physically observable and relatively stable over time.

Preventing Neighborhood Disorder: Comparing Alternative Models of Collective Efficacy Theory Using Structural Equation Modeling

Collective efficacy is a widely studied theoretical framework. Originally operationalized as the combination of social cohesion and informal social control, collective efficacy theory is a predictor of multiple positive outcomes. Conceptual and empirical critiques of collective efficacy theory suggest that social cohesion and informal social control should be modeled as unique constructs. Further, the current model of collective efficacy theory does not include an explicit measure of efficacy. Mutual efficacy, defined as community members' beliefs that collective action will be successful at attaining group goals, will be developed in this manuscript. The purpose of mutual efficacy was to make efficacy an explicit component within collective efficacy theory. Three models of collective efficacy theory are compared in this study: (a) a one-factor model of collective efficacy that combines social cohesion and informal social control, (b) a two-factor model of collective efficacy that models social cohesion as a predictor of informal social control, and (c) a mutual efficacy model where the relationship between social cohesion and informal social control is mediated by mutual efficacy. Results suggest that the two-factor model and the mutual efficacy model both fit the data better than the current model of collective efficacy.

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.

Broken (windows) theory: A meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors

The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health behaviors and outcomes. This paper identifies and meta-analyzes the evidence for three mechanisms (pathways) by which neighborhood disorder is argued to impact health, accounting for methodological inconsistencies across studies. A search identified 198 studies (152 with sufficient data for meta-analysis) testing any of the three pathways or downstream, general health outcomes. The meta-analysis found that perceived disorder was consistently associated with mental health outcomes, as well as substance abuse, and measures of overall health. This supported the psychosocial model of disadvantage, in which stressful contexts impact mental health and related sequelae. There was no consistent evidence for disorder's impact on physical health or risky behavior. Further examination revealed that support for BWT-related hypotheses has been overstated owing to data censoring and the failure to consistently include critical covariates, like socioeconomic status and collective efficacy. Even where there is evidence that BWT impacts outcomes, it is driven by studies that measured disorder as the perceptions of the focal individual, potentially conflating pessimism about the neighborhood with mental health.

Neighborhood disorder, exposure to violence, and perceived discrimination in relation to symptoms in midlife women

BACKGROUND

Some symptoms at midlife are associated with stress, such as hot flashes, trouble sleeping, headaches, or depressed mood. Hot flashes have been studied in relation to laboratory stressors, physiological biomarkers, and self-reported stress, but less is known about hot flashes in relation to the larger context of women's lives. This study examined the risk of symptoms in relation to neighborhood disorder, exposure to neighborhood violence, social cohesion and perceived discrimination. We hypothesized that women exposed to more negative neighborhood characteristics and discrimination would be more likely to report hot flashes and other midlife symptoms.

METHODS

Participants were black and white women, aged 40 to 60, drawn from a cross-sectional investigation of race/ethnicity, socioeconomic status, and blood pressure in New York City (n = 139). Demographic information, medical history, menopausal status, and symptoms were measured by questionnaire. Likert scales were used to measure neighborhood characteristics, specifically, the Neighborhood Disorder Scale, the Exposure to Violence Scale, the Perceived Violence Subscale, the Neighborhood Social Cohesion and Trust Scale, and the Everyday Discrimination Scale. Ten symptoms were included in analyses: lack of energy, feeling blue/depressed, backaches, headaches, aches/stiffness in joints, shortness of breath, hot flashes, trouble sleeping, nervous tension, and pins/needles in hands/feet. Each scale with each symptom outcome was examined using logistic regression analyses adjusting for significant covariates.

RESULTS

Black women reported higher scores on all negative neighborhood characteristics and discrimination, and a lower score on the positive Neighborhood Social Cohesion and Trust. Neighborhood Disorder was associated with feeling blue/depressed, aches/stiffness in joints, and hot flashes, and Perceived Violence was associated with aches/stiffness in joints, after controlling for model-specific covariates. There was a lower risk of backaches with increasing Neighborhood Social Cohesion and Trust score. The Everyday Discrimination Scale was associated with lack of energy. Lack of energy, feeling blue/depressed, aches/stiffness in joints, and hot flashes appeared to be most vulnerable to negative neighborhood context and discrimination.

CONCLUSIONS

This study adds to the literature linking neighborhood environments to health outcomes. The associations between negative neighborhood contexts and discrimination with diverse symptoms, and the association between social cohesion and back pain, point to the need to expand analyses of stress to multiple physiological systems.

Social and environmental determinants of physical activity in urban parks: Testing a neighborhood disorder model

The current study examined the nexus of neighborhood disorder-in the form of physical disorder (e.g., broken glass and vandalism) and social disorder (e.g., public drinking and lewd conduct)-and physical activity (PA) in urban public parks to inform public policy addressing chronic disease in at-risk populations. Five hundred and twenty-two unique observations were conducted in 22 public parks from March to September 2016. The study utilized the System for Observing Play and Recreation in Communities (SOPARC) to document age, gender, ethnicity, and PA level of park users. The Physical Activity Resource Assessment (PARA) was used to document observed physical and social disorder incivilities in public parks included in the current study. Males, adults, and Latina/os accounted for the largest number of park users, respectively. Significant PA differences were observed across gender, age, and ethnicity. Multiple linear regression controlling for gender, age, and ethnicity found physical disorder, but not social disorder, generally predicted PA reductions. While it has been demonstrated that physical disorder predicts PA reductions in low-income communities of color, this is the first study to reveal that physical disorder may lead to decreased PA in urban public parks. Thus, remediation of public park incivilities characterized by physical disorder, paired with community outreach, may lead to increased PA in at-risk communities.

How Does the Neighborhood "Come through the Door?" Concentrated Disadvantage, Residential Instability, and the Home Environment for Preschoolers

Living in a disadvantaged neighborhood is associated with heightened risk for poor school readiness and health outcomes in early childhood, and the home environment is thought to be a primary mechanism by which neighborhood context impacts preschoolers. This study examined the effects of neighborhood concentrated disadvantage and neighborhood residential instability on the home physical environment and home learning environment for preschoolers in economically disadvantaged families (N = 187). Using structural equation modeling, mothers' perceived neighborhood disorder and depressive symptoms were examined as mechanisms by which neighborhood context "comes through the door." Mothers' neighborhood social embeddedness was also explored as a protective factor. Results showed that concentrated disadvantage was negatively associated with the quality of the home physical environment, and residential instability was negatively associated with the quality of the home learning environment. Concentrated disadvantage had an indirect effect on the home learning environment through mothers' perceived neighborhood disorder and depressive symptoms. The effects of concentrated disadvantage on the home environment were buffered by mothers' neighborhood social embeddedness. Study findings advance understanding of socioeconomic- and place-based disparities in developmental outcomes and identify potential targets for interventions aimed at lessening effects of neighborhood disadvantage on families with young children.

Neighborhood disorder, peer network health, and substance use among young urban adolescents

BACKGROUND

The current study investigated the moderating effect of peer networks on neighborhood disorder's association with substance use in a sample of primarily African American urban adolescents.

METHODS

A convenience sample of 248 adolescents was recruited from urban health care settings and followed for two years, assessing psychological, social, and geographic risk and protective characteristics. A subset of 106 substance using participants were used for the analyses. A moderation model was tested to determine if the influence of neighborhood disorder (percent vacant housing, assault index, percent single parent headed households, percent home owner occupied, percent below poverty line) on substance use was moderated by peer network health (sum of peer risk and protective behaviors).

RESULTS

Evidence for hypothesized peer network moderation was supported. A latent growth model found that peer network health is most strongly associated with lower baseline substance use for young adolescents residing in more disordered neighborhoods. Over the course of two years (ages approximately 14-16) this protective effect declines, and the decline is stronger for more disordered neighborhoods.

CONCLUSIONS

Understanding the longitudinal moderating effects of peer networks within high-risk urban settings is important to the development and testing of contextually sensitive peer-based interventions.

RESULTS

suggest that targeting the potential protective qualities of peer networks may be a promising approach for interventions seeking to reduce substance use, particularly among younger urban adolescents living in high-risk neighborhoods.

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.

The Relationship between Neighborhood Disorder, Social Networks, and Indoor Cigarette Smoking among Impoverished Inner-City Residents

Impoverished urban neighborhoods tend to have higher rates of smoking and higher rates of exposure to secondhand smoke as compared to more affluent neighborhoods. Contextual factors of neighborhood disorder and social network and household composition may have an impact on indoor smoking behaviors. The TIDE study examined psychosocial factors associated with smoking behaviors among impoverished inner-city smokers in Baltimore, Maryland. Among a community-recruited sample of 413 smokers who lived with others, most (73%) reported that they or others smoked in their residence. Cohabitation with children, elderly, and those with asthma and other respiratory condition was not associated with indoor smoking. Neighborhood disorder, the proportion of social network members who smoked with the study participant, and the proportion of household members who smoked were all independently associated with smoking indoors. The study findings suggest the importance of addressing neighborhood and social network factors when developing programs for promoting indoor smoking bans as well as cessation and prevention programs.

Neighborhood disorder and glycemic control in late adolescents with Type 1 diabetes

OBJECTIVE

To evaluate the contribution of neighborhood characteristics to treatment adherence and glycemic control in late adolescents with Type 1 diabetes.

RESEARCH DESIGN AND METHODS

As part of a larger study, 220 late adolescents with Type 1 diabetes (aged 17.8 ± 0.4 years, 59.6% female, diabetes duration 7.3 ± 3.9 years) were recruited from outpatient pediatric clinics during their senior year of high school. Adolescents completed self-report measures of adherence behaviors and subjective social status, and their HbA1c values were collected during a lab assessment. Their mothers reported on their own educational achievement. These data were linked with neighborhood characteristics obtained from 2010 American Community Survey data using participants' home addresses. Based on previous work (Dulin-Keita et al., 2012), a neighborhood disorder composite score was computed from Census-tract-level variables, including percent of the population achieving less than a high school education, under 18 who lived in poverty, unemployed, receiving public assistance, and percent of households that were vacant.

RESULTS

- Adolescents with Type 1 diabetes who lived in more disordered neighborhoods were at higher risk for poorer glycemic control (p < .001), but did not report poorer adherence behaviors. The association between neighborhood disorder and HbA1c was significant after accounting for family socioeconomic status (maternal education), but not subjective social status.

CONCLUSIONS

- Results highlight the importance of neighborhood disorder for adolescents' glycemic control. The nonsignificant association between neighborhood disorder and adherence behaviors suggests physiological rather than behavioral mechanisms may be driving neighborhood SES-health outcome links.

Validation of a Google Street View-Based Neighborhood Disorder Observational Scale

Recently, there has been a growing interest in developing new tools to measure neighborhood features using the benefits of emerging technologies. This study aimed to assess the psychometric properties of a neighborhood disorder observational scale using Google Street View (GSV). Two groups of raters conducted virtual audits of neighborhood disorder on all census block groups (N = 92) in a district of the city of Valencia (Spain). Four different analyses were conducted to validate the instrument. First, inter-rater reliability was assessed through intraclass correlation coefficients, indicating moderated levels of agreement among raters. Second, confirmatory factor analyses were performed to test the latent structure of the scale. A bifactor solution was proposed, comprising a general factor (general neighborhood disorder) and two specific factors (physical disorder and physical decay). Third, the virtual audit scores were assessed with the physical audit scores, showing a positive relationship between both audit methods. In addition, correlations between the factor scores and socioeconomic and criminality indicators were assessed. Finally, we analyzed the spatial autocorrelation of the scale factors, and two fully Bayesian spatial regression models were run to study the influence of these factors on drug-related police interventions and interventions with young offenders. All these indicators showed an association with the general neighborhood disorder. Taking together, results suggest that the GSV-based neighborhood disorder scale is a reliable, concise, and valid instrument to assess neighborhood disorder using new technologies.

Does disorder get "into the head" and "under the skin"? Layered contexts and bi-directional associations

This paper utilizes a layered context approach to examine how neighborhood and household conditions are associated with the objective and subjective well-being of older adults. Using two waves of data from the National Social Life, Health, and Aging Project (n=2261), we assess subjective mental health through self-reported measures of perceived stress and distress and objective physical health through C-reactive protein (CRP). Environmental disorder was measured by independent, trained interviewers. Cross-sectional results indicate that household disorder is positively associated with perceived stress and distress, overwhelming the association between neighborhood disorder and mental health outcomes. Yet longitudinal findings point to a reverse process, whereby highly stressed women experience deterioration in their home environment across the two waves. Few significant findings surfaced for CRP. Taken together, our findings illustrate the complex interplay between health and proximal environments and underscore how feedback cycles operate between "health" and "place" across multiple outcomes.

The influence of perceived neighborhood disorder on smoking cessation among urban safety net hospital patients

BACKGROUND

Although research has shown that objective neighborhood characteristics are associated with health behaviors including smoking, little is known about the influence of perceived neighborhood characteristics on a smoking cessation attempt.

METHODS

Participants (N=139) enrolled in a Dallas safety-net hospital smoking cessation program were followed from 1 week pre-quit through 4 weeks post-quit. Logistic regression analyses were conducted to evaluate the impact of perceived neighborhood order and disorder on the likelihood of achieving biochemically verified point prevalence and continuous smoking abstinence 4 weeks following a scheduled quit attempt. Analyses were adjusted for demographic characteristics, cigarettes per day, intervention group, and pharmacological treatment.

RESULTS

Participants were primarily non-White (72.7%) and female (56.8%) with a mean age of 52.5 (SD=3.7) years. Most reported an annual household income of ≤$25,000 (86.3%). Logistic regression analyses indicated that greater neighborhood physical (p=.048) and social order (p=.039) were associated with a greater likelihood of achieving point prevalence smoking abstinence at 4 weeks post-quit. Greater perceived physical (p=.035) and social disorder (p=.039) and total neighborhood disorder (p=.014), were associated with a reduced likelihood of achieving point prevalence abstinence. Social disorder (p=.040) was associated with a reduced likelihood of achieving continuous abstinence at 4 weeks post-quit, while social order (p=.020) was associated with an increased likelihood of continuous abstinence.

CONCLUSIONS

Perceptions of neighborhood order and disorder were associated with the likelihood of smoking cessation among socioeconomically disadvantaged smokers making a quit attempt. Findings highlight the need to address perceptions of the neighborhood environment among disadvantaged smokers seeking treatment.

Do you see what I see? Perceptual variation in reporting the presence of disorder cues

A growing body of literature considers the causes of variation in perceptions of disorder; thus far, few explanations are adequate. We ask: when exposed to the same environment, do individuals homogenously report the presence of the same disorder cues? Using a dataset that cluster samples residents within city blocks and hierarchal logistic regression, we assess whether individuals residing within 1-2 blocks of each other report the same disorder cues. We find that (1) there is significant variation in reports, (2) individuals tend to disagree on the presence of disorder, not its absence, and (3) that reporting various disorder cues has significant ties to an individual's characteristics, their routine activities, and how attached they are to their neighborhood. How individuals report and interpret disorder seems to be dependent on the confluence of social, historical, economic, and place-based factors. Our results suggest revisiting the theorization of how individuals report on and interact with disorder.

The impact of neighborhood quality, perceived stress, and social support on depressive symptoms during pregnancy in African American women

Living in a lower-quality neighborhood is associated with higher levels of depressive symptoms in the general population as well as among pregnant and postpartum women. However, little is known of the important pathways by which this association occurs. We proposed a model in which perceived stress and social support mediated the effects of neighborhood quality on depressive symptoms during pregnancy (measured by the 20-item Center for Epidemiologic Studies-Depression, CES-D, scale) in a sample of 1383 African American women from the Detroit metropolitan area interviewed during their delivery hospitalization. Using structural equation modeling (SEM), we built a latent variable of neighborhood quality using 4 measures (neighborhood disorder, neighborhood safety/danger, walking environment, overall rating). We then tested two SEM mediation models. We found that lower neighborhood quality was associated with higher prevalence of depressive symptoms during pregnancy (standardized total effect = .16, p = .011). We found that perceived stress partially mediated the neighborhood quality association with depressive symptoms. Although the association of social support with depressive symptoms was negligible, social support mediated associations of neighborhood quality with perceived stress [standardized path coefficient = .38 (.02), p = .009]. Our results point to the need for public health, health care, as well as non-health related interventions (e.g. crime prevention programs) to decrease overall exposure to stressors, as well as stress levels of women living in poor quality neighborhoods. Interventions that increase the levels of social support of women during pregnancy are also needed for their potential to decrease stress and ultimately improve mental health at this important time in the life course.

Objective and perceived neighborhood characteristics and tobacco use among young adults

BACKGROUND

In the US, past month tobacco use is higher among young adults aged 18-25 years than among any other age group. Neighborhood disorder may be a malleable environmental determinant of tobacco use among young adults; its correlation with tobacco use is understudied. The purpose of this study is to examine whether perceived and objectively measured neighborhood factors are associated with tobacco use among young adults in Baltimore City.

METHODS

This cross-sectional study of predominately African American young adults (n=359) used logistic regression models via generalized estimating equations (GEE) to estimate the association of perceived and objective neighborhood disorder with past month tobacco use, adjusting for race, age, sex, income, and other substance use. Two measures of perceived neighborhood environment - neighborhood drug involvement, and neighborhood social cohesion - were derived from the Neighborhood Environment Scale (NES). Objective neighborhood disorder was measured via trained field raters using the Neighborhood Inventory for Environmental Typology (NIfETy) instrument.

RESULTS

Sex modified the relationship between perceived neighborhood drug involvement and past month tobacco use, and the association was significant among women only (aOR=1.49; 95% CI=1.19-1.88). Perceptions of neighborhood social cohesion (aOR=0.97; 95% CI=0.83-1.13), and objective neighborhood disorder (aOR=1.17; 95% CI=0.98-1.38) were not significantly associated with past month tobacco use.

CONCLUSION

Understanding the correlation between perceived and objective neighborhood disorder, and their independent association with tobacco use can potentially lead to environmentally based interventions aimed at reducing tobacco use among young adults who live in urban environments.