Sources of stress in impoverished neighbourhoods: insights into links between neighbourhood environments and health.

OBJECTIVE: This paper explores associations between residents' perceptions of social incivilities and physical disorders in local environments and self-reported health status.

METHOD: Surveys were conducted with 4,029 residents from 13 Neighbourhood Renewal sites and 1,857 residents of corresponding Local Government Areas in Victoria. An open-ended question asked respondents to nominate the worst things about living in their neighbourhood and this qualitative data was analysed for the range of perceptions of incivilities. Quantitative data analysis considered associations between incivilities in neighbourhood environments and self-reported health status.

RESULTS: Issues conceptualised as social incivilities (drug and alcohol use, dangerous driving, the behaviour of other people, feeling unsafe, noise, racism) accounted for 58% of issues nominated. Quantitative analyses suggested that increased exposure to issues related to aspects of neighbourhood safety were associated with living in a disadvantaged neighbourhood. Perceptions of lower levels of neighbourhood safety were, in turn, associated with poorer health.

CONCLUSIONS: Cumulative and compounding aspects of local environments that heighten feelings of insecurity and anxiety may be mechanisms through which places affect health.

IMPLICATIONS: While the characteristics of populations are important determinants of health outcomes, the findings endorse the value of incorporating complementary place-based approaches for addressing mechanisms that contribute to health inequalities in local environments.