Living conditions, health services use and neighborhood perception at a survey of Brasília´s suburb

Method: Probabilistic population based survey describing living conditions, health services utilization and neighborhood perception in north suburb of Brasilia. Results: 1619 dwellers were available predominantly young low schooled, mostly unemployed (60%), living in brick house with piped water and electricity (>98%); 29% had sewage system; 85% of dwellers always use the same public health facility. Sexual assaults (7%); armed fights (32%); robbery (41%) and gang fights (25%) were perceived in neighborhoods that were seen as noisy (32%), dirty (40%), with few healthy food stores (34%) and sports/leisure areas (66%). Conclusion: public policies in the capital´s suburb must be strengthened.

Explaining Racial Inequality in Food Security in Columbus, Ohio: A Blinder–Oaxaca Decomposition Analysis

Food insecurity is a leading public health challenge in the United States. In Columbus, Ohio, as in many American cities, there exists a great disparity between Black and White households in relation to food insecurity. This study investigates the degree to which this gap can be attributed to differences in food shopping behavior, neighborhood perception, and socioeconomic characteristics. A Blinder–Oaxaca decomposition method is used to analyze a household survey dataset collected in 2014. We find a 34.2 percent point difference in food security between White and Black households. Variables related to food shopping behavior, neighborhood perception, and socioeconomic characteristics explain 13.8 percent, 11.6 percent, and 63.1 percent of the difference, respectively. These independent variables combined can explain 68.2 percent of the food security gap between White and Black households. Most of this is attributable to socioeconomic variables. Sense of friendship in neighborhood, use of private vehicles, and satisfaction of neighborhood food environment also partially contribute to the food security gap.

Aspects of social participation and neighborhood perception

OBJECTIVE: To determine the impact of the physical and social surroundings of the neighborhood, which are presented as facilitators or barriers for the social participation of Brazilian older adults. METHODS: The study was conducted in a probabilistic representative sample of the Brazilian population aged 50 years and older and who lived in urban areas (n = 7,935). The response variable was social participation, which was defined from two questions about activities performed with other persons: visited friends or relatives in their homes in the last 12 months (yes, no); went out with other persons to public places, such as restaurant, movies, club, park, in the last 12 months (yes, no). The explanatory variables included fear of falling because of defects in sidewalks, concern about the difficulty to get on a bus, subway, or train, difficulty to cross streets, and perception of violence in the neighborhood. Potential confounding variables included age, marital status, education level, self-rated health, living in an asphalted or paved street, time living in the municipality, and socioeconomic position score. Prevalence ratios and respective confidence intervals were estimated using Poisson regression. RESULT: Difficulty to cross streets presented an independent association with restricted social participation (PR = 0.95; 95%CI 0.93–0.98) among both women (PR = 0.96; 95%CI 0.92–0.99) and men (PR = 0.94; 95%CI 0.90–0.99). Concern about the difficulty to get on a bus, subway, or train was associated with the outcome only among men (PR = 0.95; 95%CI 0.91–0.99). The fear of falling because of defects in sidewalks and the perception of violence in the neighborhood were not associated with social participation. CONCLUSIONS: Urban characteristics that hinder the crossing of streets and accessibility to public transport can be inferred as important barriers for the social participation of Brazilian older adults.

Mining Social Media to Measure Neighborhood Quality in the City of Atlanta

This article presents a model to classify perceptions of various Atlanta neighborhoods based on social media. Tweets were extracted using Twitter's API and categorized to determine 1) whether they are neighborhood related; 2) whether a positive or negative sentiment could be assigned, and 3) whether they belong to one of eight categories of neighborhood quality assessments. These eight categories are public safety, transportation, density, walkability, maintenance, aesthetics, open space, and quality of dining and entertainment venues. Tweets that were related to neighborhood quality and geo-tagged accounted for 4% of all filtered Tweets. Overall 49% of neighborhood perception related Tweets were extracted to create an indicator of perceived neighborhood quality. The study then compared the perception of neighborhoods from social media analysis with quantitative indicators of neighborhood quality.

Abstract P319: Changes in Perceptions of Neighborhood Environment and Cardiometabolic Outcomes in Two Predominantly African American Neighborhoods

Introduction: Perceived neighborhood characteristics, including neighborhood satisfaction, are associated with lower obesity rates and more favorable cardiovascular risk factor profiles. However, prior studies have not evaluated how longitudinal changes in perceived neighborhood characteristics following revitalization efforts may associate with cardiometabolic health indicators. Methods: Changes in neighborhood perception scales (infrastructure, safety, aesthetics, and satisfaction) were determined from 2013-2016 and categorized into the following groups: improvement, no change, or worsening over the time-period. Multivariate linear regression was used to measure the association between perceived improvement in each of the neighborhood characteristics with cardiometabolic outcomes (BMI, SBP, HbA1c, HDL-c) assessed in 2016. Outcomes were compared for those who perceived neighborhood improvements to those who perceived no change/worsening of neighborhood characteristics. Models were adjusted for age, sex, income, education, marital status, physical function, neighborhood, years spent in neighborhood. Interaction terms for age and sex were tested in the adjusted models. Results: Among the 622 individuals who did not move during the time-period, 93% were African American, 80% were female, and the mean age was 58 years. Many participants reported some improvements in neighborhood environment; infrastructure (48% reporting improvements), safety (47%), aesthetics (46%) and satisfaction (28%). In covariate-adjusted models, those who perceived improvement in their neighborhood aesthetics over the follow-up period had a significantly higher BMI (kg/m 2 ) than those who perceived no improvement/worsening (β=1.2, p=0.05). Similarly, perceived improvements in neighborhood safety were associated with higher BMI (β=1.5, p=0.01); however, they were also significantly associated with lower SBP (mmHg) (β=-3.8, p=0.01). A significant interaction was observed between sex and perceived improvement in safety when predicting BMI (interaction term p=0.04), such that the relationship between perceived improvements in safety and higher BMI was observed only among women (β=2.3, p=0.02). We did not observe any statistically significant interactions by age. We also did not find significant associations between changes in neighborhood characteristics and HDL-c or HbA1c. Conclusions: These findings suggest that perceived neighborhood characteristics may have differing associations with multiple cardiometabolic outcomes (BMI, SBP). This highlights the complexity of the associations between neighborhood characteristics and health as well as the importance of considering how changes in perceived neighborhood characteristics associate with multiple clinically relevant cardiometabolic risk factors, and how associations may be sex dependent.

Abstract P324: Association of Neighborhood Perception and Physical Activity in the Healthy Aging in Neighborhoods of Diversity Across the Lifespan (HANDLS) Study

Introduction: As obesity rates rise, it is increasingly important to understand obesity-related health behaviors, including physical activity (PA). Less is known about the role of perceived neighborhood environment, particularly perceptions of crime and violence, in preventing PA. Hypothesis: Unfavorable neighborhood perception is associated with lower PA levels, and may be moderated by socioeconomic status (SES). Methods: Within the multiracial, socioeconomically diverse HANDLS cohort, we examined the association between self-reported neighborhood perception (Likert-scale questions) and physical activity (Baecke PA questionnaire). Factor analysis identified key neighborhood characteristics to develop a total neighborhood perception score (NPS), which was divided into quintiles for analysis. Higher NPS indicated less favorable neighborhood perception. Linear regression was used to determine the relationship between total NPS, factor scores, and PA. Results: In Wave 4 [n=2167; mean age 56.6(9.1) years, 58.6% female, 61.1% black, 40.5% below poverty line], we identified five neighborhood perception factors: 1) concern about specific crime types 2) physical environment, 3) violent crime, 4) social environment and 5) violence beyond the neighborhood. Across NPS quintiles, those in quintile 5 were more likely to be younger ( p < 0.001), white ( p < 0.001), above the poverty level ( p < 0.001), and more highly educated ( p < 0.001), but less likely to be smokers ( p = 0.05) or engage in leisure time PA ( p < 0.001). Total PA decreased with increasing NPS in Factor 4 across all race/sex groups and with total NPS for white females. Total PA increased with increasing NPS in Factor 3 for white males. The NPS-PA relationship was not moderated by SES. Conclusions: Poor perceived social cohesion is associated with decreasing PA, while - paradoxically - increased perceived violent crime is associated with higher PA for white males. Further work should investigate potential mediators between social cohesion, crime and PA.