The differential impact of neighborhood cohesion on worries across racial/ethnic groups in the United States

Aim: This study evaluates whether the association between neighborhood cohesion and frequency of worry varies by racial/ethnic group in the United States (U.S.). Methods: Our study includes 89,617 respondents ages 18 and older from the National Health Interview Survey for 2013-2018. We fit multivariate linear regression models with interactions between neighborhood cohesion and race/ethnicity to test our hypotheses. Results: We find that neighborhood social cohesion is associated with a reduced frequency of worry for all groups, but the strength of this association varies by race/ethnicity. While higher levels of neighborhood cohesion are associated with less frequency of worry for adults from every racial/ethnic group, this level of protection rendered by higher perceived neighborhood cohesion is smaller for NL-Black and Latine adults, compared to NL-Whites and Asians. Conclusion: Our study suggests that examining manifestations of clinical outcomes, such as worry, among the U.S. population without considering variation by race/ethnicity may restrict our understanding of contextual factors that exacerbate or protect against these outcomes. Population-based assessments of mental health outcomes should consider whether social determinants of health operate differently by race/ethnicity.