142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

309976
Social cohesion as a mediator of the association between walkable neighborhoods and self-rated health in a Midwest city

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Stephanie Child, M.P.H. , Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
Andrew T. Kaczynski, Ph.D. , Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
Sonja Wilhelm Stanis, PhD , Department of Parks, Recreation, and Tourism, University of Missouri-Columbia, Columbia, MO
Background: Evidence suggests that built environments, specifically walkable neighborhoods, are associated with health. There are several hypotheses as to what mediates this relationship, but few studies have examined these mechanisms in the context of socioeconomic status.

Purpose: The purpose of this study was to examine whether neighborhood walking, as an indicator of physical activity, and social cohesion mediated the relationship between walkable neighborhood environments and self-rated health (SRH), and whether this relationship was moderated by income.   

Methods:  A cluster randomized sample of Kansas City, Missouri residents was taken in fall 2010.  Household surveys assessed residents’ perceptions of neighborhood walkability, social cohesion, self-reported neighborhood walking, SRH, and demographic characteristics. A multiple mediation analysis tested whether social cohesion and neighborhood walking mediated the relationship between perceived neighborhood walkability and SRH, while controlling for income and other potential confounders.

Results: A total of 811 surveys were completed. Perceptions about the walkability of the neighborhood environment were correlated with social cohesion (b=.34, p < .01), neighborhood walking (b=.13, p<.01), and SRH (b=.16, p<.01). Social cohesion mediated the relationship between neighborhood walkability and health in the uncontrolled model (b=.07, p=.02), while neighborhood walking did not (b=.02, p=.23). This effect was moderated by income, such that social cohesion was only a significant mediator of SRH in middle- to high-income respondents.

Conclusion: These data support the association between walkable environments and health, and suggest that social cohesion may play an important role in this relationship.  Yet, more research is needed in understanding the saliency of social cohesion as a health mechanism among low-income residents.

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Describe conceptual models linking neighborhood environments to health Identify potential mechanisms linking the built environment to individual health behaviors and outcomes Evaluate the role of physical activity (measured as neighborhood walking) and perceived neighborhood social cohesion in mediating the association between the presence of built environmental features that support walkability and self-rated health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present this data as I am currently a PhD student in the field of built environment and health promotion. My research interests include how walkable neighborhoods and public spaces contribute to enhanced social connectedness and health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.