Perception of neighborhood disorder and health service usage in a canadian sample

Abstract

Background Neighborhood environment, both actual and perceived, is associated with health outcomes; however, much of this research has relied on self-reports of these outcomes. Purpose The association between both perception of neighborhood disorder and neighborhood poverty (as measured by postal code socioeconomic status) was examined in the prediction of health service usage. Method Participants in a longitudinal project were contacted in mid-adulthood regarding their perception of neighborhood disorder. Their census tract data and medical records were drawn from government databases. Results Higher perceived neighborhood disorder was significantly associated with higher levels of total health services usage, lifestyle illnesses, specialist visits, and emergency room visits, even when neighborhood poverty and individual-level variables were controlled for. Neighborhood poverty was only significantly associated with fewer total hospitalizations. Conclusions Higher perceived neighborhood disorder was associated with higher rates of health service usage, suggesting further investigation into the mechanisms by which perceptions of the environment influences health outcomes. © The Society of Behavioral Medicine 2011.