Conceptualizing and operationalizing neighbourhoods - The conundrum of identifying territorial units

Background: Over the past 10 years, there has been a surge of interest in studying small-area characteristics as determinants of population and individual health. Accumulating evidence indicates the existence of variations in the health status of populations living in areas that differ in affluence and shows that selected small-area characteristics are associated with the occurrence of selected health behaviours. These variations cannot be attributed solely to differential characteristics of populations living within small areas. One vexing problem that confronts researchers is that of conceptualizing and operationalizing neighbourhoods through delineation of small territorial units in health research. Goals and Methods: The aims of this paper are to selectively overview conceptual definitions of neighbourhoods and to illustrate the challenges of operationalizing neighbourhoods in urban areas by describing our attempts to map out small territorial units on the Island of Montreal and in the City of Calgary. Conclusion: We outline guiding principles for the construction of a methodology for establishing small-area contours in urban areas and formulate recommendations for future research.