Neighborhoods and health: A systematic review of health effects of neighborhoods based on definition of neighborhood boundary

While there is wide appreciation that neighborhood environments play a role in determining health outcomes, the magnitude of effects neighborhood environments have in determining health outcomes appears to vary greatly in the public health literature. While one group of studies will demonstrate strong associations between neighborhood factors and a given health or health-related outcome, others contradict these findings by showing little to no association.  These differences in findings may be due to several factors, including the specific public health outcome being studied, the neighborhood metrics being used to evaluate neighborhood-level factors, and—most relevant to this discussion—the definition of neighborhood boundary.

This project seeks to demonstrate and attempts to understand this variability in outcomes due to differing neighborhood boundary definition.  We will present findings from a systematic review of the literature examining how neighborhood boundary definition relates to congruence in conclusions drawn between neighborhood-level factors and a variety of health determinants and outcomes.  Targeted health determinants and outcomes include perceived and objectively measured neighborhood environment, health behaviors (such as engaging in leisure time physical activity), and direct metrics of health (such as cancer prevalence, cardiovascular disease prevalence, etc.). 

Specifically, we will discuss common trends (and differences) in health and health-related outcomes observed within specific definitions of neighborhood boundary, including  administrative boundaries like census tracts, distance based boundaries (such as buffer zones), or more “organic” boundaries that might be created based on on-the-ground observation or community input. Overall, this review will inform future research on whether different neighborhood boundaries would be more appropriate for measuring specific health outcomes than others.