Social cohesion, neighbourhood resilience, and health: evidence from New Deal for Communities programme. (13th November 2015)

• Record Type: Journal Article
• Authors: Gordeev, Vladimir S; Egan, Matt
• Is Part Of: Lancet. Volume 386(2015)Supplement 2
• Page Start: S39
• Publication Date: 2015-11-13
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(15)00877-6
• Languages: English
• ISSNs: 0140-6736

Abstract

Abstract: Background: The contribution of socioeconomic determinants to health is well established, whereas the role of contextual and environmental factors, such as social community cohesion and control, remains understudied. These factors could possibly be the drivers of neighbourhood resilience, and hence help to explain variation in health among residents of communities situated in similarly disadvantaged neighbourhoods. This study aimed to assess the effects of different dimensions of social cohesion on resilience and health in disadvantaged neighbourhoods in the UK. Methods: To explore which elements of social cohesion are associated with self-assessed health and mental health of residents living in communities in disadvantaged neighbourhoods, we conducted secondary data analysis using four waves (2002–08) of biannual repeat cross-sectional surveys collected for the New Deal for Communities programme (about 17 710 individuals per wave). Ten items depicting community social cohesion were subjected to principal axis factor analysis with varimax rotation. Two-level logit models accounted for the clustering of residents (level 1) within 39 areas (level 2), and were used to estimate the likelihood of reporting good self-assessed health and good mental health. To check robustness, analyses were repeated on pooled data after excluding duplications. Findings: Three social cohesion factors explained 54·4% of the total variance (Kaiser-Meyer-Olkin 0·784; χ 2 =36890·26, df=45, p<0·0001) and were classified as trust in local organisations, social network and neighbourliness, and control and participation. After adjustment for baseline and sociodemographic characteristics, two social cohesion factors (trust in local organisations, and social network and neighbourliness) were associated with good self-assessed health (odds ratio 1·29 [95% CI 1·22–1·35] and 1·09 [1·04–1·15], respectively). Associations with control and participation were not significant. Findings for mental health showed a similar pattern. Interpretation: Our preliminary results illustrate the importance of social cohesion, particularly of trust in local organisations and social network and neighbourliness for self-assessed and mental health among residents of disadvantaged neighbourhoods. These findings support recent public health strategies that emphasise the importance of community cohesion and control to promote neighbourhood resilience and initiatives aimed at reduction of health and social inequalities. Funding: This work was supported by the National Institute for Health Research (NIHR) School for Public Health Research.