Abstract
Background
Some research concerned with place and health has used the study of opportunity structures in neighbourhoods to understand how place might get under the skin. It has become somewhat common to assume that objective indicators of opportunity structures are in some way equivalent to people’s access to them. The general objective of this study, therefore, was to evaluate the level of convergence between objective and subjective evaluations of neighbourhood resources in Winnipeg, Canada.
Methods
Winnipeg residents (n=1,102) were sampled from 59 neighbourhood units to permit hierarchical linear modelling and to enable the testing of Winnipeg residents’ individual-level subjective appraisals within neighbourhood-level objective characteristics. Several databases provided objective neighbourhood data on premature mortality rates, crime, housing, recreation programs, education, and household income. To evaluate subjective appraisals of these resources, data were gathered from the Winnipeg Quality of Life Survey (WQLS).
Results
We found that, when controlling for individual- and neighbourhood-level confounders, the objective data at hand match relatively well with participants’ subjective perceptions of housing and crime, while neighbourhood-level premature mortality rates and the objective numbers of recreation programs across neighbourhood are not significant predictors of their subjective counterparts.
Conclusion
It may be that objective measures of some opportunity structures should be accompanied by subjective measures to ensure a more complete understanding of the impact of these resources on population health.
MeSH terms: Health resources, residence characteristics, population health, Manitoba
Résumé
Contexte
Quelques recherches qui s’intéressent aux rapports entre le lieu et la santé se sont inspirées de l’étude des « structures de possibilités » présentes dans les quartiers pour comprendre comment les milieux de vie affectent notre santé. On prend souvent pour acquis que les indicateurs objectifs des structures de possibilités équivalent grosso modo à l’utilisation de ces structures par la population. Nous avons voulu vérifier le degré de convergence entre les évaluations objectives et subjectives des ressources des quartiers à Winnipeg, au Canada.
Méthodes
Des résidants de Winnipeg (n=1 102) ont été échantillonnés dans 59 unités de voisinage afin de permettre une modélisation linéaire hiérarchique et pour mesurer les évaluations subjectives des résidants de Winnipeg par rapport aux caractéristiques objectives des quartiers. Plusieurs banques de données ont fourni des données objectives par quartier sur les taux de mortalité prématurée, la criminalité, le logement, les programmes récréatifs, l’instruction et le revenu des ménages. Pour mesurer les évaluations subjectives de ces ressources, nous avons regroupé des données tirées de l’enquête Winnipeg Quality of Life Survey (WQLS).
Résultats
Nous avons constaté, après rajustement des données pour tenir compte des facteurs de confusion individuels et collectifs, que les données objectives étaient à peu près équivalentes à la perception subjective des participants en ce qui a trait au logement et à la criminalité, mais que les taux de mortalité prématurée et le nombre réel de programmes récréatifs dans les quartiers n’étaient pas des prédicteurs significatifs de leurs équivalents subjectifs.
Conclusion
Pour mieux comprendre l’impact de certaines structures de possibilités sur la santé de la population, il faudrait peut-être ajouter des mesures subjectives de ces ressources aux mesures objectives déjà utilisées.
Footnotes
Acknowledgements: The first author acknowledges the editorial comments of Louise Potvin and Lise Gauvin as well as the diligent work of Sarine Lory Hovsepian who helped pull together much of the literature review.
The Winnipeg Quality of Life Survey (WQLS) was funded by the Winnipeg Inner-City Research Alliance and Neighbourhoods Alive. Support for the crime, housing and recreation databases was provided as part of a grant to the fourth author from the Canadian Population Health Initiative (Manitoba Health project number 2000-159). The results and conclusions are those of the authors; we are grateful to Health Information Services, Manitoba Health and the Office of Vital Statistics in the Agency of Consumer and Corporate Affairs for providing data. No official endorsement by either Manitoba Health or the Office of Vital Statistics is intended or implied.
References
- 1.Pickett KE, Pearl M. Multilevel analyses of neighbourhood socioeconomic context and health outcomes: A critical review. J Epidemiol Community Health. 2001;55:111–22. doi: 10.1136/jech.55.2.111. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Kawachi I, Berkman LF. Neighbourhoods and Health. New York: Oxford University Press; 2003. [Google Scholar]
- 3.Cummins S, Stafford M, Macintyre S, Marmot M, Ellaway A. Neighbourhood environment and its association with self rated health: Evidence from Scotland and England. J Epidemiol Community Health. 2005;59:207–13. doi: 10.1136/jech.2003.016147. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Macintyre S, Mckay L, Ellaway A. Are rich people or poor people more likely to be ill? Lay perceptions, by social class and neighbourhood of inequalities in health. Soc Sci Med. 2005;60:313–17. doi: 10.1016/j.socscimed.2004.08.001. [DOI] [PubMed] [Google Scholar]
- 5.Veenstra G, Luginaah I, Wakefield S, Birch S, Eyles J, Elliott S. Who you know, where you live: Social capital, neighbourhood and health. Soc Sci Med. 2005;60:2799–818. doi: 10.1016/j.socscimed.2004.11.013. [DOI] [PubMed] [Google Scholar]
- 6.McMichael AJ. Prisoners of the proximate: Loosening the constraints on epidemiology in an age of change. Am J Epidemiol. 1999;149:887–97. doi: 10.1093/oxfordjournals.aje.a009732. [DOI] [PubMed] [Google Scholar]
- 7.Roos LL, Magoon J, Gupta S, Chateau D, Veugelers PJ. Socioeconomic determinants of mortality in two Canadian provinces: Multilevel modelling and neighborhood context. Soc Sci Med. 2004;59:1435–47. doi: 10.1016/j.socscimed.2004.01.024. [DOI] [PubMed] [Google Scholar]
- 8.Yen IH, Kaplan GA. Neighbourhood social environment and risk of death: Multilevel evidence from the Alameda county study. Am J Epidemiol. 1999;149:898–907. doi: 10.1093/oxfordjournals.aje.a009733. [DOI] [PubMed] [Google Scholar]
- 9.Pampalon R, Duncan CC, Subramanian SV, Jones K. Geographies of health perception in Quebec: A multilevel perspective. Soc Sci Med. 1999;48:1483–90. doi: 10.1016/S0277-9536(99)00043-X. [DOI] [PubMed] [Google Scholar]
- 10.Frohlich KL, Potvin L, Gauvin L, Chabot P. Youth smoking initiation: Disentangling context from composition. Health and Place. 2002;8:155–66. doi: 10.1016/S1353-8292(02)00003-5. [DOI] [PubMed] [Google Scholar]
- 11.Ross NA, Tremblay S, Graham K. Neighbourhood influences on health in Montreal, Canada. Soc Sci Med. 2004;59:1485–94. doi: 10.1016/j.socscimed.2004.01.016. [DOI] [PubMed] [Google Scholar]
- 12.Macintyre S, MacIver S, Sooman A. Area, class and health: Should we be focusing on places or people? J Social Policy. 1993;22:213–34. doi: 10.1017/S0047279400019310. [DOI] [Google Scholar]
- 13.Macintyre S, Ellaway A. Social and local variations in the use of urban neighbourhoods: A case study in Glasgow. Health and Place. 1998;4:91–94. doi: 10.1016/S1353-8292(97)00030-0. [DOI] [PubMed] [Google Scholar]
- 14.Macintyre S. The social patterning of exercise behaviours: The role of personal and local resources. Br J Sports Med. 2000;34:6. doi: 10.1136/bjsm.34.1.6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Miles R. Neighborhood disorder and smoking: Findings of a European urban survey. Soc Sci Med. 2006;63:2464–75. doi: 10.1016/j.socscimed.2006.06.011. [DOI] [PubMed] [Google Scholar]
- 16.Sooman A, Macintyre S. Health and perceptions of the local environment in socially contrasting neighbourhoods in Glasgow. Health and Place. 1995;1:15–26. doi: 10.1016/1353-8292(95)00003-5. [DOI] [Google Scholar]
- 17.Ellaway A, Macintyre S. Does where you live predict health related behaviours?: A case study in Glasgow. Health Bulletin. 1996;54:443–46. [PubMed] [Google Scholar]
- 18.Macintyre S, Ellaway A. Neighbourhoods and health: An overview. In: Kawachi I, Berkman LF, editors. Neighbourhoods and Health. New York: Oxford University Press; 2003. pp. 20–42. [Google Scholar]
- 19.Baum F, Palmer C. ‘Opportunity structures’: Urban landscape, social capital and health promotion in Australia. Health Prom Int. 2002;17:351–61. doi: 10.1093/heapro/17.4.351. [DOI] [PubMed] [Google Scholar]
- 20.Raphael D, Steinmetz B, Renwick R, Rootman I, Brown I, Sehdev H, Phillips S, Smith T. The Community Quality of Life Project: A health promotion approach to understanding communities. Health Promot Int. 1999;14:197–210. doi: 10.1093/heapro/14.3.197. [DOI] [Google Scholar]
- 21.Sirgy MJ, Rahtz DR, Cicic M, Underwood R. A method for assessing residents’ satisfaction with community-based services: A quality-of-life perspective. Social Indicators Research. 2000;49:279–316. doi: 10.1023/A:1006990718673. [DOI] [Google Scholar]
- 22.Kirtland KA, Porter DE, Addy CL, Neet MJ, Williams JE, Sharpe PA, et al. Environmental measures of physical activity supports: Perception versus reality. Am J Prev Med. 2003;24:323–31. doi: 10.1016/S0749-3797(03)00021-7. [DOI] [PubMed] [Google Scholar]
- 23.Addy CL, Wilson DK, Kirtland KA, Ainsworth BE, Sharpe P, Kimsey D. Associations of perceived social and physical environmental supports with physical activity and walking behaviour. Am J Public Health. 2004;94:440–43. doi: 10.2105/AJPH.94.3.440. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Hoehner CM, Ramirez LKB, Elliott MB, Handy SL, Brownson RC. Perceived and objective environmental measures and physical activity among urban adults. Am J Prev Med. 2005;28:105–16. doi: 10.1016/j.amepre.2004.10.023. [DOI] [PubMed] [Google Scholar]
- 25.Dillman D. Mail and Telephone Surveys: The Total Design Method. New York: John Wiley and Sons; 1978. [Google Scholar]
- 26.City of Winnipeg Community Services Department. Housing Policy: Neighbourhood Housing Indicator Data. 2000. [Google Scholar]
- 27.Bryk AS, Raudenbush SW. Hierarchical Linear Models: Applications and Data Analysis Methods. Newbury Park, CA: Sage; 1992. [Google Scholar]
- 28.Frohlich N, Mustard CA. A regional comparison of socioeconomic and health indices in a Canadian province. Soc Sci Med. 1996;42:1273–81. doi: 10.1016/0277-9536(95)00220-0. [DOI] [PubMed] [Google Scholar]
- 29.Martens PJ, Frohlich N, Carriere KC, Derksen S, Brownell M. Embedding child health within a framework of regional health: Population health status and sociodemographic indicators. Can J Public Health. 2002;93(Suppl.2):S15–S20. doi: 10.1007/BF03403613. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Widgery RN. Neighbourhood quality of life: A subjective matter? Developments in Quality-of-Life Studies in Marketing. 1992;IV:112–14. [Google Scholar]