Including stroke and heart attack?
Use of preventive health services?
Neighborhood social cohesion refers to the perceived degree of connectedness between and among neighbors and their willingness to take action for the common good. Greater neighborhood social cohesion predicts better overall health. Stroke is a leading cause of disability in the US. Would greater social cohesion predict lower risk of stroke? Researchers at the University of Michigan used data from 6,740 participants in the sixth wave of the Health and Retirement Survey to investigate this possibility. Participants were at least 50 years of age at baseline and had no history of stroke. Responses to the following four statements measured perceived neighborhood social cohesion: 1) I really feel part of this area. 2) Most people in this area can be trusted. 3) If you were in trouble, there are lots of people in this area who would help you. 4) Most people in this area are friendly. Participants rated on the degree to which they agreed with each statement on a seven-point scale.
Over four years of follow-up, 265 participants had a stroke. After accounting for age, gender, chronic illnesses, marital status, education, and total wealth, participants with higher perceived social cohesion had a 15 percent significantly lower risk of stroke compared to participants with lower social cohesion. After further accounting for a host of negative and positive psychosocial factors, the risk of stroke declined slightly to 13 percent and remained statistically significant. Thus, high perceived neighborhood social cohesion independently predicted risk of stroke. Improving neighborhood social cohesion might be an effective way to help older people reduce their risk of a debilitating stroke.
In another report that used data from the Health and Retirement Study, researchers linked perceived neighborhood social cohesion to risk of a heart attack (aka myocardial infarction). In 2006, a random sample of Study participants completed a questionnaire that included four items relating to neighborhood social cohesion (the same statements and rating scale as above). Of the 5,276 study participants with an average of 70 years, 148 had a heart attack over four years of follow-up. Each standard deviation increased in perceived neighborhood social cohesion predicted a 22 percent decline in risk of heart attack
Researchers at Harvard University used data from the Health and Retirement Study to determine if older people in neighborhoods with greater social cohesion made greater use of preventive health services. A total of 7,168 participants with an average age of 69 years contributed data for the study. The researchers found that higher perceived neighborhood social cohesion predicted significantly greater use of flu vaccinations, cholesterol tests, mammograms, and pap smears, but not prostate screenings. Lack of association with prostate screening might reflect the fact that screenings can't identify aggressive versus non-aggressive prostate cancer. Plus, diagnosis and treatment of prostate cancer entail considerable risks, including incontinence and impotence. Nevertheless, it appears that neighborhood groups might be a means to disseminate health information and increase its use in the community. Living in a socially cohesive neighborhood might keep you healthier.