ArticleDefining Neighborhood Boundaries for Urban Health Research
Introduction
The body of literature exploring neighborhood effects on health has increased rapidly in recent years.1, 2, 3 Social, institutional, and physical characteristics of neighborhoods are being linked to a variety of health behaviors4, 5, 6 and outcomes7 including substance abuse,8, 9 asthma,10 cardiovascular disease,11, 12 birth outcomes,13, 14, 15 respiratory infections,16 sexually transmitted diseases,17 cancer,18 and all-cause mortality.19, 20, 21, 22 Methodologic concerns remain,3, 23, 24, 25, 26, 27, 28 however, including specification of social, institutional, and physical characteristics of neighborhoods that should be included in such research, appropriate methods for collecting neighborhood data (e.g., resident surveys, secondary source data, and/or direct, systematic observation), and guidelines for identification and delineation of study neighborhoods.
Interest in neighborhoods and the impact they have on residents has spanned decades and disciplines,29, 30, 31, 32 including sociology, child development, and public health. There is a general, if not unanimous, consensus within the literature that neighborhood refers to a geographic unit of limited size, with relative homogeneity in housing and population, as well as some level of social interaction and symbolic significance to residents.33, 34 The subjectivity of neighborhood boundaries, demonstrated repeatedly in empirical research,35, 36 is also widely accepted.37 Social connections, common use of public facilities (e.g., schools, shopping areas), and physical barriers (e.g., major thoroughfares) may contribute to overlap in residents’ neighborhood definitions, but their perceptions are also affected by individual characteristics, such as gender, age, and daily activities.34, 38, 39 Particularly in cities, where local travel is easy and frequent, neighborhood boundaries are likely to be malleable.
Given the difficulties inherent in neighborhood delineation, public health researchers have most often opted for predefined boundaries consistent with sociodemographic and health data available from secondary sources (e.g., census tracts in the United States, electoral wards in the United Kingdom).26 Predefined boundaries are easily identified, replicable, and obviously allow for the use of secondary source data. Their disadvantage rests in possible discrepancies with contemporary settlement patterns and resident perceptions of neighborhood boundaries. Local-level variability may be obscured within these preselected units, particularly if they are too large.26 In addition, exclusive reliance on secondary source boundaries may be inefficient for studies involving primary data collection, as it may be impossible to discern, prior to the start of data collection, if factors of interest are present in the selected geographic areas. Despite these limitations, there is little in the public health literature suggesting that alternative methods for delineating neighborhood boundaries have been attempted.26 Direct observations and elicitation of resident perceptions of neighborhood boundaries represent alternatives to predefined boundaries but are generally dismissed as subjective, inconsistent (internally and with respect to secondary source data), and/or labor intensive.17, 23, 25
This article describes methods used for defining neighborhood boundaries for research purposes that supplement census block group information with reviews of publicly available land-use data and systematic observation. The objective in combining these methods was the selection of neighborhood boundaries consistent with census data, study recruitment goals, and residence patterns. A secondary objective was to ensure that the range of environmental characteristics to be examined in the research was present in study neighborhoods.
Section snippets
Background
Inner-City Mental Health Study Predicting HIV/AIDS, Club and Other Drug Transitions (IMPACT) is a 5-year, multilevel neighborhood study aimed at (1) identifying associations among features of the social and physical urban environment, sexual and drug use risk behavior, and HIV prevalence in New York City (NYC) neighborhoods and (2) evaluating interrelations between features of the urban social and physical environment that shape individual sexual and drug use risk behavior and that may
Methods
An essential step in the implementation of the study was to delineate boundaries for each of the 36 neighborhoods that could then be used to establish sampling frames and as key units of analytic interest. Consistency regarding census data was considered necessary, so that sociodemographic and other publicly available data could be incorporated into analyses. The degree to which any particular census-defined area was appropriate for study purposes could not be determined from secondary source
Results
Defined neighborhoods range from 1 to 8 census block groups, with populations (according to the 2000 census)44 ranging from 2252 to 11,503 (mean=5320) (Table 1). Most neighborhoods included in the study had a majority black (12 neighborhoods) or Latino (17 neighborhoods) population. The percent of population below poverty ranged from 9.7% to 65.9% (mean=40.0%), compared with 21.2% for NYC as a whole.45 Eighteen neighborhoods included public housing, in all (five neighborhoods) or in part
Discussion
Despite the growing body of literature exploring neighborhood effects on health, little attention has been paid to processes for neighborhood delineation. Most researchers use predefined boundaries consistent with secondary source data, despite shortcomings, which include possible obfuscation of local level variability and inconsistency with respect to the social or environmental factors being examined. For research involving primary data collection, including surveys or systematic
Conclusion
Neighborhood boundary definitions are subjective, varying even among residents. Consequently, there is no one precise way to delineate a “neighborhood.” A multistep process that begins with the development of census maps and reviews of published land use as well as census data for targeted communities, and continues with systematic street-level observations, is a relatively efficient methodology that allows for consideration of a range of factors commonly used in neighborhood definition,
References (46)
- et al.
Place effects on health: how can we conceptualize, operationalize and measure them?
Soc Sci Med
(2002) - et al.
Smoking and deprivation: are there neighborhood effects?
Soc Sci Med
(1999) - et al.
Infant mortality: a multi-level analysis of individual and community risk
Soc Sci Med
(1998) - et al.
Measuring neighborhood social and material context: generation and interpretation of ecological data from routine and non-routine sources
Health Place
(2005) - et al.
The influence of community factors on health: an annotated bibliography
(2004) - et al.
The contextual effect of the local food environment on resident’s diets: the Atherosclerosis Risk in Community study
Am J Public Health
(2002) - et al.
Poverty area residence and changes in physical activity level: evidence from the Alameda County Study
Am J Public Health
(1998) - et al.
Neighborhood effects on health: exploring the links and assessing the evidence
J Urban Aff
(2001) - et al.
Effects of race, neighborhood, and social network on age at initiation of injection drug use
Am J Public Health
(2005)
The substance use system: social and neighborhood environments associated with substance use and misuse
Subst Use Misuse
Putting asthma into context: community influences on risk, behavior, and intervention
Residential environments and cardiovascular risk
J Urban Health
Neighborhood of residence and incidence of coronary heart disease
N Engl J Med
Neighborhood risk factors for low birthweight in Baltimore: a multilevel analysis
Am J Public Health
Preterm birth: the interaction of traffic-related air pollution with economic hardship in Los Angeles neighborhoods
Am J Epidemiol
Motor vehicle exhaust and chronic respiratory symptoms in children living near freeways
Environ Res
“Broken windows” and the risk of gonorrhea
Am J Public Health
Examining Urban brownfields through the public health “macroscope.”
Environ Health Persp
The relation of residential segregation to all-cause mortality: a study in black and white
Am J Public Health
Neighborhood socio-economic status and all-cause mortality
Am J Epidemiol
Poverty and health: prospective evidence from the Alameda County Study
Am J Epidemiol
Phantom of the area: poverty-area residence and mortality in the United States
Am J Public Health
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