Characteristics of an individual alone cannot exhaustively explain all the causes of poor health, and neighborhood of residence have been suggested to be one of the factors that contribute to health. However, knowledge about aspects of the neighborhood that are most important to health is limited. The main objective of this study was to explore associations between certain features of neighborhood environment and self-rated health and depressive symptoms in Maastricht (The Netherlands). A large amount of routinely collected neighborhood data were aggregated by means of factor analysis to 18 characteristics of neighborhood social and physical environment. Associations between these characteristics and self-rated health and presence of depressive symptoms were further explored in multilevel logistic regression models adjusted for individual demographic and socio-economic factors. The study sample consisted of 9,879 residents (mean age 55 years, 48 % male). Residents of unsafe communities were less likely to report good health (OR 0.88 95 % CI 0.80–0.97) and depressive symptoms (OR 0.81 95 % CI 0.69–0.97), and less cohesive environment was related to worse self-rated health (OR 0.81 95 % CI 0.72–0.92). Residents of neighborhoods with more car traffic nuisance and more disturbance from railway noise reported worse mental health (OR 0.79 95 % CI 0.68–0.92 and 0.85 95 % CI 0.73–0.99, respectively). We did not observe any association between health and quality of parking and shopping facilities, facilities for public or private transport, neighborhood aesthetics, green space, industrial nuisance, sewerage, neighbor nuisance or satisfaction with police performance. Our findings can be used to support development of integrated health policies targeting broader determinants of health. Improving safety, social cohesion and decreasing traffic nuisance in disadvantaged neighborhoods might be a promising way to improve the health of residents and reduce health inequalities.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Mackenbach, J. P., Karanikolos, M., & McKee, M. (2013). The unequal health of Europeans: Successes and failures of policies. Lancet, 381(9872), 1125–1134. doi:10.1016/S0140-6736(12)62082-0.
Marmot, M., Allen, J., Bell, R., et al. (2012). WHO European review of social determinants of health and the health divide. Lancet, 380(9846), 1011–1029. doi:10.1016/S0140-6736(12)61228-8.
Pickett, K., & Wilkinson, R. (2011). The spirit Level: Why greater equality makes societies stronger. New York: Bloomsbury press.
Diez Roux, A. V. (2007). Neighborhoods and health: Where are we and were do we go from here? Revue d’Epidemiologie et de Sante Publique, 55(1), 13–21. doi:10.1016/j.respe.2006.12.003.
Pickett, K. E., & Pearl, M. (2001). Multilevel analyses of neighbourhood socioeconomic context and health outcomes: A critical review. Journal of Epidemiology and Community Health, 55(2), 111–122.
Riva, M., Gauvin, L., & Barnett, T. A. (2007). Toward the next generation of research into small area effects on health: A synthesis of multilevel investigations published since July 1998. Journal of Epidemiology and Community Health, 61(10), 853–861. doi:10.1136/jech.2006.050740.
Ellaway, A., Benzeval, M., Green, M., Leyland, A., & Macintyre, S. (2012). “Getting sicker quicker”: Does living in a more deprived neighbourhood mean your health deteriorates faster? Health and Place, 18(2), 132–137. doi:10.1016/j.healthplace.2011.08.005.
Jongeneel-Grimen, B., Busschers, W., Droomers, M., van Oers, H. A., Stronks, K., & Kunst, A. E. (2013). Change in neighborhood traffic safety: Does it matter in terms of physical activity? PLoS One, 8(5), e62525. doi:10.1371/journal.pone.0062525.
Jongeneel-Grimen, B., Droomers, M., Stronks, K., van Oers, J. A., & Kunst, A. E. (2013). Migration and geographical inequalities in health in the Netherlands: An investigation of age patterns. International Journal of Public Health,. doi:10.1007/s00038-013-0459-0.
Agyemang, C., van Hooijdonk, C., Wendel-Vos, W., Lindeman, E., Stronks, K., & Droomers, M. (2007). The association of neighbourhood psychosocial stressors and self-rated health in Amsterdam, The Netherlands. Journal of Epidemiology and Community Health, 61(12), 1042–1049. doi:10.1136/jech.2006.052548.
Cummins, S., Stafford, M., Macintyre, S., Marmot, M., & Ellaway, A. (2005). Neighbourhood environment and its association with self rated health: Evidence from Scotland and England. Journal of Epidemiology and Community Health, 59(3), 207–213. doi:10.1136/jech.2003.016147.
GGD Zuid Limburg. (2010). Een gezonde kijk op Zuid-Limburg. Regionale Volksgezondheid Toekomstverkenning 2010. Geleen 2010.
GGD Zuid Limburg. (2008). Monitor gegevens2008.
GGD Zuid Limburg. (2005). Monitor gegevens2005.
de Hollander AEM, Hoeymans N, Melse JM, van Oers JAM, Polder JJ. Zorg voor gezondheid. (2006). Volksgezondheid toekomst verkenning 2006. Bilthoven2006.
Kessler, R. C., Andrews, G., Colpe, L. J., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976.
Merlo, J., Chaix, B., Ohlsson, H., et al. (2006). A brief conceptual tutorial of multilevel analysis in social epidemiology: Using measures of clustering in multilevel logistic regression to investigate contextual phenomena. Journal of Epidemiology and Community Health, 60(4), 290–297. doi:10.1136/jech.2004.029454.
Twisk, J. (2006). Applied multilevel analyses. Cambridge: Cambridge university press.
StataCorp. (2011). Stata statistical software: Release 12. College station, TX: StataCorp LP.
Sundquist, K., Theobald, H., Yang, M., Li, X., Johansson, S. E., & Sundquist, J. (2006). Neighborhood violent crime and unemployment increase the risk of coronary heart disease: A multilevel study in an urban setting. Social Science and Medicine, 62(8), 2061–2071. doi:10.1016/j.socscimed.2005.08.051.
Ross, C. E., & Mirowsky, J. (2001). Neighborhood disadvantage, disorder, and health. Journal of Health and Social Behavior, 42(3), 258–276.
Wilson-Genderson, M., & Pruchno, R. (2013). Effects of neighborhood violence and perceptions of neighborhood safety on depressive symptoms of older adults. Social Science and Medicine, 85, 43–49. doi:10.1016/j.socscimed.2013.02.028.
Yoon, H., & Jang, Y. (2014). Self-rated mental health in socio-structural contexts: An examination with Korean American older adults. Aging and mental health,. doi:10.1080/13607863.2013.878685.
Gilbert, K. L., Quinn, S. C., Goodman, R. M., Butler, J., & Wallace, J. (2013). A meta-analysis of social capital and health: A case for needed research. Journal of health psychology, 18(11), 1385–1399. doi:10.1177/1359105311435983.
Pearce, N., & Davey Smith, G. (2003). Is social capital the key to inequalities in health? American Journal of Public Health, 93(1), 122–129.
Kawachi, I., Kennedy, B. P., Lochner, K., & Prothrow-Stith, D. (1997). Social capital, income inequality, and mortality. American Journal of Public Health, 87(9), 1491–1498.
Murayama, H., Fujiwara, Y., & Kawachi, I. (2012). Social capital and health: A review of prospective multilevel studies. Journal of Epidemiology/Japan Epidemiological Association, 22(3), 179–187.
Kim, E. S., Park, N., & Peterson, C. (2013). Perceived neighborhood social cohesion and stroke. Social Science and Medicine, 97, 49–55. doi:10.1016/j.socscimed.2013.08.001.
Bassett, E., & Moore, S. (2013). Social capital and depressive symptoms: The association of psychosocial and network dimensions of social capital with depressive symptoms in Montreal. Canada Social Science and Medicine, 86, 96–102. doi:10.1016/j.socscimed.2013.03.005.
Ziersch, A. M., Baum, F., Darmawan, I. G., Kavanagh, A. M., & Bentley, R. J. (2009). Social capital and health in rural and urban communities in South Australia. Australian and New Zealand Journal of Public Health, 33(1), 7–16. doi:10.1111/j.1753-6405.2009.00332.x.
Bassett, E., & Moore, S. (2013). Gender differences in the social pathways linking neighborhood disadvantage to depressive symptoms in adults. PLoS One, 8(10), e76554. doi:10.1371/journal.pone.0076554.
Banerjee, D., Das, P. P., & Foujdar, A. (2014). Association between road traffic noise and prevalence of coronary heart disease. Environmental Monitoring and Assessment, 186(5), 2885–2893. doi:10.1007/s10661-013-3587-3.
Bocquier, A., Cortaredona, S., Boutin, C., et al. (2014). Is exposure to night-time traffic noise a risk factor for purchase of anxiolytic-hypnotic medication? A cohort study. European Journal of Public Health, 24(2), 298–303. doi:10.1093/eurpub/ckt117.
Welch, D., Shepherd, D., Dirks, K. N., McBride, D., & Marsh, S. (2013). Road traffic noise and health-related quality of life: A cross-sectional study. Noise and health, 15(65), 224–230. doi:10.4103/1463-1741.113513.
Dratva, J., Zemp, E., Felber Dietrich, D., et al. (2010). Impact of road traffic noise annoyance on health-related quality of life: Results from a population-based study. Quality of Life Research an International Journal of Quality of Life Aspects of Treatment Care and Rehabilitation, 19(1), 37–46. doi:10.1007/s11136-009-9571-2.
Passchier-Vermeer, W., & Passchier, W. F. (2000). Noise exposure and public health. Environmental Health Perspectives, 108(Suppl 1), 123–131.
Stansfeld, S. A., & Matheson, M. P. (2003). Noise pollution: Non-auditory effects on health. British Medical Bulletin, 68, 243–257.
Miles, R., Coutts, C., & Mohamadi, A. (2012). Neighborhood urban form, social environment, and depression. Journal of Urban Health Bulletin of the New York Academy of Medicine, 89(1), 1–18. doi:10.1007/s11524-011-9621-2.
Mair, C., Diez Roux, A. V., & Morenoff, J. D. (2010). Neighborhood stressors and social support as predictors of depressive symptoms in the Chicago community adult health study. Health and Place, 16(5), 811–819. doi:10.1016/j.healthplace.2010.04.006.
Cummins, S., Macintyre, S., Davidson, S., & Ellaway, A. (2005). Measuring neighbourhood social and material context: Generation and interpretation of ecological data from routine and non-routine sources. Health and Place, 11(3), 249–260. doi:10.1016/j.healthplace.2004.05.003.
Diez Roux, A. V. (2001). Investigating neighborhood and area effects on health. American Journal of Public Health, 91(11), 1783–1789.
Diez Roux, A. V., & Mair, C. (2010). Neighborhoods and health. Annals of the New York Academy of Sciences, 1186, 125–145. doi:10.1111/j.1749-6632.2009.05333.x.
Gephart, M. (1997). Neighborhood and communities as contexts for developement. In J. Brooks-Gunn, C. Duncan, & J. Aber (Eds.), Neighborhood poverty, volume I: Context and consequences for children (pp. 1–43). New York: Russell Sage Foundation.
Michael, Y., Beard, T., Choi, D., Farquhar, S., & Carlson, N. (2006). Measuring the influence of built neighborhood environments on walking in older adults. Journal of Aging and Physical Activity, 14(3), 302–312.
Auchincloss, A. H., Diez Roux, A. V., Mujahid, M. S., Shen, M., Bertoni, A. G., & Carnethon, M. R. (2009). Neighborhood resources for physical activity and healthy foods and incidence of type 2 diabetes mellitus: The multi-ethnic study of atherosclerosis. Archives of Internal Medicine, 169(18), 1698–1704. doi:10.1001/archinternmed.2009.302.
Kramer, D., Maas, J., Wingen, M., & Kunst, A. E. (2013). Neighbourhood safety and leisure-time physical activity among Dutch adults: A multilevel perspective. The international journal of behavioral nutrition and physical activity, 10, 11. doi:10.1186/1479-5868-10-11.
Veldhuizen, E. M., Stronks, K., & Kunst, A. E. (2013). Assessing associations between socio-economic environment and self-reported health in Amsterdam using bespoke environments. PLoS One, 8(7), e68790. doi:10.1371/journal.pone.0068790.
Schisterman, E. F., Cole, S. R., & Platt, R. W. (2009). Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology, 20(4), 488–495. doi:10.1097/EDE.0b013e3181a819a1.
Macintyre, S., & Elleway, A. (2000). Ecological approaches: Rediscovering the role of the physical and social environment. In L. Berkman & I. Kawachi (Eds.), Social epidemiology (pp. 332–348). New York: Oxford University Press.
Jongeneel-Grimen, B., Droomers, M., Stronks, K., & Kunst, A. E. (2011). Migration does not enlarge inequalities in health between rich and poor neighbourhoods in The Netherlands. Health and Place, 17(4), 988–995. doi:10.1016/j.healthplace.2011.03.008.
Zuid Limburg. (2011). Een gezonde koers voor Zuid-Limburg. Regionale nota gezondheidbeleid Zuid-Limburg 2012–2015.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Putrik, P., de Vries, N.K., Mujakovic, S. et al. Living Environment Matters: Relationships Between Neighborhood Characteristics and Health of the Residents in a Dutch Municipality. J Community Health 40, 47–56 (2015). https://doi.org/10.1007/s10900-014-9894-y
- Social and physical environment
- Self-rated health
- Depressive symptoms
- Socio-economic inequalities