Journal of Urban Health

, Volume 90, Issue 5, pp 857–871 | Cite as

The Urban Built Environment and Associations with Women’s Psychosocial Health

  • Lynne C. MesserEmail author
  • Pamela Maxson
  • Marie Lynn Miranda


The determinants that underlie a healthy or unhealthy pregnancy are complex and not well understood. We assess the relationship between the built environment and maternal psychosocial status using directly observed residential neighborhood characteristics (housing damage, property disorder, tenure status, vacancy, security measures, violent crime, and nuisances) and a wide range of psychosocial attributes (interpersonal support evaluation list, self-efficacy, John Henryism active coping, negative partner support, Perceived Stress Scale, perceived racism, Center for Epidemiologic Studies—Depression) on a pregnant cohort of women living in the urban core of Durham, NC, USA. We found some associations between built environment characteristic and psychosocial health varied by exposure categorization approach, while others (residence in environments with more rental property is associated with higher reported active coping and negative partner support) were consistent across exposure categorizations. This study outlines specific neighborhood characteristics that are modifiable risk markers and therefore important targets for increased research and public health intervention.


Pregnancy outcomes Built environment Psychosocial health Urban health 



This work was supported by a grant from the US Environmental Protection Agency (RD-83329301).


  1. 1.
    Behrman R, Butler A. Preterm birth: causes, consequences, and prevention. Washington: National Academies; 2007.Google Scholar
  2. 2.
    Canfield M, Ramadhani T, Langlois P, Waller D. Residential mobility patterns and exposure misclassification in epidemiologic studies of birth defects. J Expo Sci Environ Epidemiol. 2006; 16: 538–543.CrossRefGoogle Scholar
  3. 3.
    Clark C, Myron R, Stansfield S, Candy B. A systematic review of the evidence on the effect of the built and physical environment on mental health. J Publ Ment Health. 2007; 6: 14–27.CrossRefGoogle Scholar
  4. 4.
    Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, eds. The social psychology of health. New York: Sage; 1988: 31–67.Google Scholar
  5. 5.
    Cohen S, Mermelstein R, Kamarack T, Hoberman H. Measuring the functional components of social support. In: Sarason I, Sarason B, eds. Social support: theory, research and applications. Dordrecht, The Netherlands: Martinus Nijhoff; 1985: 73–94.CrossRefGoogle Scholar
  6. 6.
    Demissie A, Siega-Riz AM, Evenson KR, Herring AH, Dole N, Gaynes BN. Physical activity and depressive symptoms among pregnant women: the PIN3 study. Arch Women’s Mental Health. 2011; 14(2): 145–57.Google Scholar
  7. 7.
    Evans G. The built environment and mental health. J Urban Health. 2003; 80: 536–555.PubMedCrossRefGoogle Scholar
  8. 8.
    Friis R, Wittchen H-U, Prister H, Lieb R. Life events and changes in the course of depression in young adults. Eur Psychiatry. 2002; 17: 241–253.PubMedCrossRefGoogle Scholar
  9. 9.
    Galea S, Ahern J, Vlahov D, Coffin P, Fuller C, Leon A, Tardiff K. Income distribution and risk of fatal drug overdose in New York City neighborhoods. Drug Alcohol Depend. 2003; 70: 139–148.CrossRefGoogle Scholar
  10. 10.
    Galea S, Ahern J, Rudenstine S, Wallace Z, Vlahov D. Urban built environment and depression: a multilevel analysis. J Epidemiol Community Health. 2005; 59: 822–827.CrossRefGoogle Scholar
  11. 11.
    Geronimus A. Damned if you do: culture, identity, privilege, and teenage childbearing in the United States. Soc Sci Med. 2003; 57: 881–893.CrossRefGoogle Scholar
  12. 12.
    Geronimus A. Teenage childbearing as cultural prism. Br Med J. 2004; 69: 155–166.Google Scholar
  13. 13.
    Hack M, Klein N, Taylor H. Long term developmental outcomes of low birth weight infants. The future of children: low birth weight. Los Altos: Center for the Future of Children; 1995: 19–34.Google Scholar
  14. 14.
    Headen I, Davise E, Mujahid M, Abrams B. Racial–ethnic differences in pregnancy-related weight. Adv Nutr. 2012; 3: 83–94.PubMedCrossRefGoogle Scholar
  15. 15.
    James S. The John Henryism Scale for active coping. In: Jones R, ed. Handbook of tests and measurements for Black populations. Hampton: Cobb & Henry; 1996: 415–425.Google Scholar
  16. 16.
    Jerusalem M, Schwarzer R. Self-efficacy as a resource factor in stress appraisal processes. In: Schwarzer R, ed. Self-efficacy: thought control of action. Washington: Hemisphere; 1992.Google Scholar
  17. 17.
    Kim D. Blues from the neighborhood? Neighborhood characteristics and depression. Epidemiol Rev. 2008; 30: 101–117.PubMedCrossRefGoogle Scholar
  18. 18.
    Kramer M, Hogue C. What causes racial disparities in very preterm birth? A biosocial perspective. Epidemiol Rev. 2009; 31: 84–98.PubMedCrossRefGoogle Scholar
  19. 19.
    Kramer M, Seguin L, Lydon J, Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol. 2000; 14: 194–210.PubMedCrossRefGoogle Scholar
  20. 20.
    Krieger N. Racial and gender discrimination: risk factors for high blood pressure. Soc Sci Med. 1990; 30: 1273–1281.PubMedCrossRefGoogle Scholar
  21. 21.
    Leventhal T, Brooks-Gunn J. A randomized study of neighborhood effects on low-income children's educational outcomes. Dev Psychol. 2004; 40: 488–507.PubMedCrossRefGoogle Scholar
  22. 22.
    Mair C, Diez-Roux A, Galea S. Are neighbourhood characteristics associated with depressive symptoms? A review of evidence. J Epidemiol Community Health. 2008; 62: 940–946.Google Scholar
  23. 23.
    Matheson F, Moineddin R, Dunn J, Creatore M, Gozdyra P, Glazier R. Urban neighbourhoods, chronic stress, gender and depression. Soc Sci Med. 2006; 63: 2604–2616.PubMedCrossRefGoogle Scholar
  24. 24.
    Maxson PJ, Edwards SE, Ingram A, Miranda ML. Psychosocial differences between smokers and non-smokers during pregnancy. Addict Behav. 2012; 37(2): 153–9.Google Scholar
  25. 25.
    McLanahan S, Garfinkel I, Reichman N, Teitler J, Carlson M, Audigier C. The fragile families and child-wellbeing study: baseline national report. Princeton: Princeton University; 2003.Google Scholar
  26. 26.
    Orr ST, Miller CA. Maternal depressive symptoms and the risk of poor pregnancy outcome: review of the literature and preliminary findings. Epidemiol Rev. 1995; 17: 165–171.Google Scholar
  27. 27.
    Radloff L. The CES—D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977; 1: 385–401.CrossRefGoogle Scholar
  28. 28.
    Srinivasan S, O'Fallon L, Dearry A. Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health. Am J Public Health. 2003; 93: 1446–1450.PubMedCrossRefGoogle Scholar
  29. 29.
    Steptoe A, Feldman P. Neighborhood problems as sources of chronic stress: development of a measure of neighborhood problems, and associations with socioeconomic status and health. Ann Behav Med. 2001; 23: 177–185.PubMedCrossRefGoogle Scholar
  30. 30.
    Tester G, Ruel E, Anderson A, Reitzes D, Oakely D. Sense of place among Atlanta public housing residents. J Urban Health. 2011; 88: 436–453.PubMedCrossRefGoogle Scholar
  31. 31.
    Vinikoor L, Messer L, Evenson K, Laraia B. Neighborhood incivilities, social spaces, walkability, and arterial indices are associated with maternal health behaviors and pregnancy outcomes. Soc Sci Med. 2011; 73: 1302–1311.CrossRefGoogle Scholar
  32. 32.
    Weich S, Blanchard M, Prince M, Burton E, Eens B, Sproston K. Mental health and the built environment: cross-sectional survey of individual and contextual risk factors for depression. Br J Psychiatry. 2002; 180: 428–433.PubMedCrossRefGoogle Scholar
  33. 33.
    Yen I, Yelin E, Katz P, Eisner M, Blanc P. Perceived neighborhood problems and quality of life, physical functioning, and depressive symptoms among adults with asthma. Am J Public Health. 2006; 96: 873–879.PubMedCrossRefGoogle Scholar

Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  • Lynne C. Messer
    • 1
    • 2
    Email author
  • Pamela Maxson
    • 1
  • Marie Lynn Miranda
    • 3
  1. 1.Children’s Environmental Health Initiative, Nicholas School of the EnvironmentDuke UniversityDurhamUSA
  2. 2.Center for Health and Inequalities Research, Duke Global Health InstituteDuke UniversityDurhamUSA
  3. 3.School of Natural Resources and Environment and Department of PediatricsUniversity of MichiganAnn ArborUSA

Personalised recommendations