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      Rating neighborhoods for older adult health: results from the African American Health study

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          Social theories suggest that neighborhood quality affects health. Observer ratings of neighborhoods should be subjected to psychometric tests.


          African American Health (AAH) study subjects were selected from two diverse St. Louis metropolitan catchment areas. Interviewers rated streets and block faces for 816 households. Items and a summary scale were compared across catchment areas and to the resident respondents' global neighborhood assessments.


          Individual items and the scale were strongly associated with both the catchment area and respondent assessments. Ratings based on both block faces did not improve those based on a single block face. Substantial interviewer effects were observed despite strong discriminant and concurrent validity.


          Observer ratings show promise in understanding the effect of neighborhood on health outcomes. The AAH Neighborhood Assessment Scale and other rating systems should be tested further in diverse settings.

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          Most cited references 27

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          Systematic Social Observation of Public Spaces: A New Look at Disorder in Urban Neighborhoods

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            Beyond Social Capital: Spatial Dynamics of Collective Efficacy for Children

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              Investigating neighborhood and area effects on health.

              The past few years have witnessed an explosion of interest in neighborhood or area effects on health. Several types of empiric studies have been used to examine possible area or neighborhood effects, including ecologic studies relating area characteristics to morbidity and mortality rates, contextual and multilevel analyses relating area socioeconomic context to health outcomes, and studies comparing small numbers of well-defined neighborhoods. Strengthening inferences regarding the presence and magnitude of neighborhood effects will require addressing a series of conceptual and methodological issues. Many of these issues relate to the need to develop theory and specific hypotheses on the processes through which neighborhood and individual factors may jointly influence specific health outcomes. Important challenges include defining neighborhoods or relevant geographic areas, identifying significant area or neighborhood characteristics, specifying the role of individual-level variables, incorporating life-course and longitudinal dimensions, combining a variety of research designs, and avoiding reductionism in the way in which "neighborhood" factors are incorporated into models of disease causation and quantitative analyses.analyses.

                Author and article information

                BMC Public Health
                BMC Public Health
                BioMed Central
                25 January 2008
                : 8
                : 35
                [1 ]Department of Epidemiology and Biostatistics, College of Public Health and Health Professions, University of Florida Health Sciences Center, PO Box 100231 Gainesville, FL 32610, USA
                [2 ]Department of Neurology & Psychiatry, School of Medicine, Saint Louis University, 1438 South Grand Boulevard, St. Louis, MO 63104, USA
                [3 ]Iowa City Veterans Affairs Medical Center, Highway 6 West, Iowa City, Iowa 52246, USA
                [4 ]Department of Health Management and Policy, College of Public Health, University of Iowa, 200 Hawkins Drive, E205 General Hospital, Iowa City, Iowa 52242, USA
                [5 ]Departments of Medicine and Pediatrics, School of Medicine, Washington University, Campus Box 8504, 660 South Euclid Avenue, St. Louis, MO 63110, USA
                [6 ]Division of Biostatistics, School of Medicine, Washington University, Campus Box 8067, 660 South Euclid Avenue, St. Louis, MO 63110, USA
                [7 ]Indiana University Center for Aging Research, School of Medicine, Indiana University, IN, USA
                [8 ]Regenstrief Institute, Inc., 410 West 10th Street, Suite 2000, Indianapolis, IN 46202, USA
                Copyright © 2008 Andresen et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Research Article

                Public health


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