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September 3, 2021BMC Public HealthOpen Access

Association between neighborhood social cohesion, awareness of chronic diseases, and participation in healthy behaviors in a community cohort

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Key result

Each 1-point increase in neighborhood social cohesion links to ~24% less cigarette use among Whites.

Why the study?

Higher neighborhood social cohesion is associated with improved cardiovascular health primarily in Whites rather than African Americans, prompting investigation into its association with chronic disease awareness and healthy self-management behaviors.

Is higher neighborhood social cohesion associated with improved awareness of chronic diseases and participation in healthy behaviors in a bi-racial community cohort?

Population

2082 bi-racial participants in the HANDLS study

Comparison

Different levels of neighborhood social cohesion

Design

Cross-sectional study

Authors

ARAndrew RosenblattDCDeidra C. CrewsNPNeil R. Powe

Discussion

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Member takes

Overview

NSC may support select healthy behaviors without aiding awareness; hypothesis-generating and needs prospective trials before practice implications.

Study Design

Type

Cross-Sectional (n=2,082)

Structured PICO

Is higher neighborhood social cohesion associated with improved awareness of chronic diseases and participation in healthy behaviors in a bi-racial community cohort?

P
Population
2,082 community-dwelling adults, mean age 56.5 years, 59.1% female, 38.7% White and 61.4% African American, from Baltimore City, USA. 26.3% had diabetes, 70% had hypertension, and 20.2% had chronic kidney disease.
I
Intervention
Higher neighborhood social cohesion (NSC) score (measured on a 1-5 scale)
C
Comparator
Lower neighborhood social cohesion (NSC) score
O
Outcome
Awareness of chronic conditions (diabetes, chronic kidney disease, and hypertension) and engagement in healthy self-management behaviors (physical activity, healthy eating, and cigarette avoidance)patient reported

Main Result

Effect estimate: aOR 0.76 (95% CI 0.61-0.94)

Higher neighborhood social cohesion is associated with greater engagement in healthy behaviors like physical activity and, among White individuals, healthier eating and less smoking, but not with awareness of chronic diseases.

Limitations

  • Cross-sectional design prevents inferring causality
  • Reverse causality cannot be ruled out
  • Potential residual confounding
  • CKD status was defined by single measurements of eGFR or albuminuria, potentially leading to misclassification
  • Self-reported participation in healthy behaviors may introduce social desirability bias
  • Lacked data on the racial composition of individual neighborhoods
  • Potential selection bias from differences in who agrees to participate and remain in the longitudinal cohort

Cite This Study

Rosenblatt et al. (2021) conducted a cross-sectional in Community-dwelling adults (n=2,082). Neighborhood social cohesion (NSC) was evaluated on Cigarette use among Whites (per 1-point increase in mean NSC score) (aOR 0.76, 95% CI 0.61-0.94). Higher neighborhood social cohesion was not associated with chronic disease awareness, but each higher point in mean NSC score was associated with less cigarette use (aOR 0.76) and healthier eating among White participants.

synapsesocial.com/papers/6a1224f78edbaba0bf66bb63https://doi.org/10.1186/s12889-021-11633-8
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