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      Self-rated health and its association with perceived environmental hazards, the social environment, and cultural stressors in an environmental justice population

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          Abstract

          Background

          Communities with large minority populations often are located near sources of pollution and have higher crime rates, which may work in combination with other factors to influence health. Poor self-rated health is related to chronic health conditions and premature mortality, with minority populations most likely to report poor health. To address how both resident perception of neighborhood environments and chronic health conditions individually and collectively influence health, we examined self-rated health and its association with multiple types of perceived environmental hazards in a majority-Hispanic urban population.

          Methods

          We conducted interviews with 354 residents of Chelsea, Massachusetts, US and asked about self-rated health, perceptions of their neighborhood, including participant-reported environmental hazards (e.g., air quality, odors and noise), aspects of the social environment (e.g., feeling safe, neighborhood crime, social cohesion), and culture-related stressors (e.g., immigration status, language stress, ethnic identity). Log-linear models examined the independent and multivariable associations between these factors and fair/poor self-rated health, controlling for socio-demographic characteristics and preexisting health conditions.

          Results

          Forty-one percent of participants reported fair/poor self-rated health. Participants frequently perceived environmental hazards such as problems with pests and regular noise disturbance as well as feeling unsafe. In a multivariable model, a greater number of reported noise disturbances (≥ 2 noise sources = 1.53 [1.04–2.26]) and reported insecurity with immigration status (1.66 [1.01–2.73]) were positively associated with fair/poor self-rated health. High social cohesion was inversely associated (0.74 [0.48–1.14]) with fair/poor self-rated health in the multivariable model.

          Conclusions

          Negative perceptions of environmental hazards and reported cultural stressors were significantly associated with fair/poor self-rated health among residents in a low-income majority-minority community, with social cohesion having a beneficial association with self-rated health. Efforts to improve health should recognize the importance of public perceptions of social and environmental hazards found in neighborhood environments, and benefits of strengthening community connections.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-018-5797-7) contains supplementary material, which is available to authorized users.

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          Most cited references27

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          The Multigroup Ethnic Identity Measure: A New Scale for Use with Diverse Groups

          J. Phinney (1992)
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            Objective and perceived neighborhood environment, individual SES and psychosocial factors, and self-rated health: an analysis of older adults in Cook County, Illinois.

            This article investigates the relationship among objectively assessed neighborhood socio-economic status (SES), subjective perceptions of neighborhood environment, individual SES and psychosocial factors, and self-rated health among middle-aged and older adults. Analysis of data from a representative sample of adults, aged 50-67 years in Cook County, Illinois, shows a significant association between objective neighborhood SES and self-rated health after controlling for age, gender, and race/ethnicity, but the effect is substantially explained by individual SES and neighborhood perceptions. By contrast, perceived neighborhood quality (i.e., subjective ratings of neighborhood physical, social, and service environments) exhibits a significant effect after controlling for individual socio-demographic factors as well as neighborhood SES. In turn, the effects of perceived neighborhood environment on health are partially explained by the psychosocial factors of loneliness, depression, hostility, and stress, but not by perceived social support or social networks. In sum, the research supports a model in which the effects of neighborhood SES on self-rated health act through sequential pathways of individual SES, perceptions of neighborhood quality, and psychosocial status.
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              Dichotomous or categorical response? Analysing self-rated health and lifetime social class.

              Self-rated health is a commonly used measure of health status, usually having three to five categories. The measure is often collapsed into a dichotomous variable of good versus less than good health. This categorization has not yet been justified. Using data from the 1958 British birth cohort, we examined the relationship between socioeconomic conditions, indicated by occupational class at four ages, and self-rated health. Results obtained for a dichotomous variable using logistic regression were compared with alternative methods for ordered categorical variables including polytomous regression, cumulative odds, continuation ratio and adjacent categories models. Findings concerning the relationship between socioeconomic position and self-rated health yielded by a logistic regression model were confirmed by alternative statistical methods which incorporate the ordered nature of self-rated health. Similarity of results was found regarding size and significance of main effects, type of association and interactive effects.
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                Author and article information

                Contributors
                judy.ou@hci.utah.edu
                petersj@bu.edu
                jonlevy@bu.edu
                roseannb@greenrootschelsea.org
                arossini@bu.edu
                MLS@bu.edu
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                3 August 2018
                3 August 2018
                2018
                : 18
                : 970
                Affiliations
                [1 ]ISNI 0000 0004 1936 7558, GRID grid.189504.1, Boston University School of Public Health, ; Boston, MA USA
                [2 ]ISNI 0000 0004 0422 3447, GRID grid.479969.c, Huntsman Cancer Institute at the University of Utah, ; Salt Lake City, UT USA
                [3 ]GreenRoots Inc, Chelsea, MA 02150 USA
                Article
                5797
                10.1186/s12889-018-5797-7
                6090753
                30075713
                dd85332a-4b3b-4080-b107-de7d2e38d26b
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 5 September 2017
                : 4 July 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000139, U.S. Environmental Protection Agency;
                Award ID: RD83458201
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Public health
                Public health

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