Did the UK COVID-19 Lockdown Modify the Influence of Neighbourhood Disorder on Psychological Distress? Evidence From a Prospective Cohort Study

Background: National lockdown in the UK during the COVID-19 pandemic severely restricted the mobility of residents and increased time spent in their residential neighbourhoods. This is a unique opportunity to understand how an exogenous factor that reduces mobility may influence the association between neighbourhood social environment and mental health. This study investigates whether the COVID-19 lockdown may modify the effect of neighbourhood disorder on psychological distress.Methods: We tracked changes in psychological distress, using the UK household longitudinal survey across the pre-COVID and lockdown periods in 16,535 adults. Neighbourhood disorder was measured along two subscales: social stressors and property crime. Fixed-effects regression was used to evaluate whether the widespread reduction in mobility modifies the association between the subscales of neighbourhood disorder and psychological distress.Results: The effect of neighbourhood social stressors on psychological distress was stronger in the lockdown period compared to the pre-COVID period. Compared to the pre-COVID period, the effect of being in neighbourhoods with the highest social stressors (compared to the lowest) on psychological distress increased by 20% during the lockdown. Meanwhile, the effect of neighbourhood property crime on mental health did not change during the lockdown.Conclusion: The sudden loss of mobility as a result of COVID-19 lockdown is a unique opportunity to address the endogeneity problem as it relates to mobility and locational preferences in the study of neighbourhood effects on health. Vulnerable groups who have limited mobility are likely more sensitive to neighbourhood social stressors compared to the general population.

An empirical application of “broken windows” and related theories in healthcare: examining disorder, patient safety, staff outcomes, and collective efficacy in hospitals

Background Broken windows theory (BWT) proposes that visible signs of crime, disorder and anti-social behaviour – however minor – lead to further levels of crime, disorder and anti-social behaviour. While we acknowledge divisive and controversial policy developments that were based on BWT, theories of neighbourhood disorder have recently been proposed to have utility in healthcare, emphasising the potential negative effects of disorder on staff and patients, as well as the potential role of collective efficacy in mediating its effects. The aim of this study was to empirically examine the relationship between disorder, collective efficacy and outcome measures in hospital settings. We additionally sought to develop and validate a survey instrument for assessing BWT in hospital settings. Methods Cross-sectional survey of clinical and non-clinical staff from four major hospitals in Australia. The survey included the Disorder and Collective Efficacy Survey (DaCEs) (developed for the present study) and outcome measures: job satisfaction, burnout, and patient safety. Construct validity was evaluated by confirmatory factor analysis (CFA) and reliability was assessed by internal consistency. Structural equation modelling (SEM) was used to test a hypothesised model between disorder and patient safety and staff outcomes. Results The present study found that both social and physical disorder were positively related to burnout, and negatively related to job satisfaction and patient safety. Further, we found support for the hypothesis that the relationship from social disorder to outcomes (burnout, job satisfaction, patient safety) was mediated by collective efficacy (social cohesion, willingness to intervene). Conclusions As one of the first studies to empirically test theories of neighbourhood disorder in healthcare, we found that a positive, orderly, productive culture is likely to lead to wellbeing for staff and the delivery of safer care for patients.

Adolescents´ Perceptions, Neighbourhood Characteristics and Parental Monitoring -Are they Related, and Do they Interact in the Explanation of Adolescent Offending?

Children are nested in families, and families are nested within communities (e.g. neighbourhoods). This implies that the behaviour of both children and their parents is influenced by external and contextual factors. The aim of the present study was to explore the relationship between parental monitoring and neighbourhood disorder and collective efficacy from the perspective of the adolescent and to investigate how perceived monitoring and neighbourhood characteristics were related to and interact in predicting adolescent offending. The characteristics of the adolescent’s neighbourhoods were assessed using two different data sources: adolescents’ own perceptions and an independent, aggregated measure from a community survey. The analyses showed that the adolescents’ perceptions of neighbourhood level of disorder and collective efficacy were associated with both adolescent-perceived parental monitoring and adolescent offending, while the corresponding measures from the community survey were not. As regards the prediction of offending, adolescent-perceived parental monitoring is the most important predictor. Neither collective efficacy nor disorder appear to interact with parental monitoring in explaining adolescent offending. Future research would contribute to the field by examining the effect and interaction between the study variables in a sample with younger adolescents as well as by including parents’ perceptions. As to practical implications, our results indicate that families living in disadvantaged neighbourhoods may benefit from targeted support aimed at handling negative neighbourhood influences.

Is perceived neighbourhood physical disorder associated with muscle strength in middle aged and older men and women? Findings from the US health and retirement study

BackgroundResearch documenting the relevance of neighbourhoods for the health of older adults has focused on global physical functioning outcomes, such as disability, rather than physiologic impairments that lead to disability. Muscle weakness is an age-related impairment and a central mechanism of disability. Evaluating neighbourhood effects on muscle weakness may offer insight into physiologic mechanisms of disability. We examined the association between perceived neighbourhood disorder and muscle strength in a nationally representative sample of US adults aged 51+.MethodsAmong 11 277 participants (57% women; mean age: 66.6 years) in the Health and Retirement Study (2012–2014), we investigated whether self-reported neighbourhood physical disorder (1–7 scale, mean=2.61, SD=1.45); presence of vandalism/graffiti, litter, deserted houses, feeling safe walking alone) was associated with mean hand grip strength using linear regression models with sampling weights. We tested whether the association between neighbourhood disorder and grip strength differed by age and gender.ResultsAfter adjusting for demographic characteristics, marital status, education and household wealth, residence in neighbourhoods with high perceived physical neighbourhood disorder was associated with lower muscle strength for men (β=−1.95 kg; 95% CI, 2.68 to –1.22) and to a lesser extent, for women (β=−0.64 kg, 95% CI, −1.11 to –0.19), (p for interaction <0.0001). For both men and women, associations between neighbourhood physical disorder and grip strength were more adverse among the middle aged (51–64 years) than for older (ages 65+) adults.DiscussionPerceived neighbourhood disorder was associated with lower muscle strength. Future studies should more rigorously evaluate causality and evaluate potential interventions.

Improving mental health through neighbourhood regeneration: the role of cohesion, belonging, quality and disorder

Poor mental health has been associated with socioeconomic deprivation. The aim was to describe possible mechanisms underpinning the narrowing of mental health inequalities demonstrated by Communities First, an area-wide regeneration programme in Wales, UK. Propensity score matched data from the Caerphilly Health and Social Needs Electronic Cohort Study, assessed changes in mental health, neighbourhood-level social cohesion, belongingness, quality and disorder. A multiple mediation analysis found c.76% of the total indirect effect was accounted for by neighbourhood quality and disorder. Targeted regeneration that increases neighbourhood quality and reduced neighbourhood disorder could mitigate the mental health inequalities associated with socioeconomic deprivation.

What Is the Relationship between the Neighbourhood Built Environment and Time Spent in Outdoor Play? A Systematic Review

Outdoor play has been associated with children’s and adolescents’ healthy development and physical activity. Attributes of the neighbourhood built environment can influence play behaviours. This systematic review examined the relationship between attributes of the neighbourhood built environment and the time children and adolescents (0–18 years) spend in self-directed outdoor play. We identified and evaluated 18 relevant papers using the Mixed Methods Appraisal Tool and developed a narrative synthesis of study results. We found moderate evidence that lower traffic volumes (ages 6–11), yard access (ages 3–10), and increased neighbourhood greenness (ages 2–15) were positively associated with time spent in outdoor play, as well as limited evidence that specific traffic-calming street features such as fewer intersections, low traffic speeds, neighbourhood disorder, and low residential density were positively associated with time spent in outdoor play. To our knowledge, this is the first systematic review on this topic. The limited number of “good quality” studies identified highlights the need for additional research on the topic.

The Effects of Neighbourhood Disorder on Life Satisfaction of Ethnic Majority and Minority Group Members: Evidence From 12 Central-Eastern European Countries

While research has shown a negative relation between neighbourhood disorder and indicators of well-being, this evidence comes predominantly from Western European countries, relies on subjective measures of disorder, and is indifferent to ethnic specificities. In this paper, we examine the relationship between neighbourhood disorder and life satisfaction across neighbourhoods in 12 Central-Eastern European countries. We use an exogenous measure of disorder, and account for the presence of respondents’ own ethnic group in the neighbourhood, as we propose that it may condition the effect of disorder on life satisfaction. Using survey data covering 18,743 residents of 897 local areas across 12 countries, we found that neighbourhood disorder was negatively related to life satisfaction for both ethnic majority and minority respondents, over and above individual and neighbourhood characteristics. This effect was, however, differently moderated by ethnic in-group share in the neighbourhood for ethnic majorities and minorities. Among ethnic majority members, disorder had a negative effect on their life satisfaction only when there were high levels of co-ethnics' presence in the neighbourhood, but not at low levels. By contrast, for minority members, the negative effect of neighbourhood disorder was significant at lower of levels of co-ethnic concentration, but not at its higher levels. These results suggest that whereas for minority groups the presence of co-ethnics buffers the negative effects of the aversive environment on well-being, for ethnic majority members it plays an opposite role. We argue that members of the dominant, majority population find having to attribute disorder to their in-group problematic, which results in lower life satisfaction.

Greener Pastures

This chapter focuses on a special survey conducted of the residents of Ethel Lawrence Homes (EHL) and nonresidents to assess how moving into the project affected the residential environment people experienced on a day-to-day basis. The design of the survey compares neighbourhood conditions experienced by EHL residents both before and after they moved into the project, as well as to compare them with a control group of people who had applied to EHL but had not yet been admitted. Both comparisons reveal a dramatic reduction in exposure to neighbourhood disorder and violence and a lower frequency of negative life events as a result of the move. By the time EHL finally opened in 2000, it was no longer a test case about the rights of longtime residents not to be forced out of their hometown. Instead, it became a test case for whether affordable housing developments could provide a path out of poverty for the urban poor, and what kinds of costs such programs might impose on suburban residents.

Differential vulnerability to neighbourhood disorder: a gene×environment interaction study

BackgroundType 2 diabetes (T2D) is preventable, it is increasing in prevalence and it is a major risk factor for morbidity and mortality. Importantly, residents of neighbourhoods with high levels of disorder are more likely to develop T2D than those living in less disordered neighbourhoods and neighbourhood disorder may exacerbate genetic risk for T2D.MethodWe use genetic, self-reported neighbourhood, and health data from the Health and Retirement Study. We conducted weighted logistic regression analyses in which neighbourhood disorder, polygenic scores for T2D and their interaction predicted T2D.ResultsGreater perceptions of neighbourhood disorder (OR=1.11, p<0.001) and higher polygenic scores for T2D (OR=1.42, p<0.001) were each significantly and independently associated with an increased risk of T2D. Furthermore, living in a neighbourhood perceived as having high levels of disorder exacerbated genetic risk for T2D (OR=1.10, p=0.001). This significant gene×environment interaction was observed after adjusting for years of schooling, age, gender, levels of physical activity and obesity.ConclusionFindings in the present study suggested that minimising people’s exposure to vandalism, vacant buildings, trash and circumstances viewed by residents as unsafe may reduce the burden of this prevalent chronic health condition, particularly for subgroups of the population who carry genetic liability for T2D.