The importance of social context: Neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders

被引:251
作者
Stockdale, Susan E. [1 ]
Wells, Kenneth B.
Tang, Lingqi
Belin, Thomas R.
Zhang, Lily
Sherbourne, Cathy D.
机构
[1] Univ Calif Los Angeles, Semel Inst Hlth Serv Res Ctr, Los Angeles, CA 90095 USA
[2] RAND Corp, Santa Monica, CA USA
[3] Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA USA
关键词
neighborhood effects; stress; social support; mental health; substance abuse; USA;
D O I
10.1016/j.socscimed.2007.05.045
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
This study examines the relationship among neighborhood stressors, stress-buffering mechanisms, and likelihood of alcohol, drug, and mental health (ADM) disorders in adults from 60 US communities (n = 12,716). Research shows that larger support structures may interact with individual support factors to affect mental health, but few studies have explored buffering effects of these neighborhood characteristics. We test a conceptual model that explores effects of neighborhood stressors and stress-buffering mechanisms on ADM disorders. Using Health Care for Communities with census and other data, we found a lower likelihood of disorders in neighborhoods with a greater presence of stress-buffering mechanisms. Higher neighborhood average household occupancy and churches per capita were associated with a lower likelihood of disorders. Cross-level interactions revealed that violence-exposed individuals in high crime neighborhoods are vulnerable to depressive/anxiety disorders. Likewise, individuals with low social support in neighborhoods with high social isolation (i.e., low-average household occupancy) had a higher likelihood of disorders. If replicated by future studies using longitudinal data, our results have implications for policies and programs targeting neighborhoods to reduce ADM disorders. (C) 2007 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1867 / 1881
页数:15
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