Skip to main content
SpringerLink
Log in

Engaging Urban Residents in Assessing Neighborhood Environments and Their Implications for Health

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Researchers have worked to delineate the manner in which urban environments reflect broader social processes, such as those creating racially, ethnically and economically segregated communities with vast differences in aspects of the built environment, opportunity structures, social environments, and environmental exposures. Interdisciplinary research is essential to gain an enhanced understanding of the complex relationships between these stressors and protective factors in urban environments and health. The purpose of this study was to examine the ways that multiple factors may intersect to influence the social and physical context and health within three areas of Detroit, Michigan. We describe the study design and results from seven focus groups conducted by the Healthy Environments Partnership (HEP) and how the results informed the development of a survey questionnaire and environmental audit tool. The findings from the stress process exercise used in the focus groups described here validated the relevance of a number of existing concepts and measures, suggested modifications of others, and evoked several new concepts and measures that may not have been captured without this process, all of which were subsequently included in the survey and environmental audit conducted by HEP. Including both qualitative and quantitative methods can enrich research and maximize the extent to which research questions being asked and hypotheses being tested are driven by the experiences of residents themselves, which can enhance our efforts to identify strategies to improve the physical and social environments of urban areas and, in so doing, reduce inequities in health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

  1. Galea S, Vlahov D. Urban health: evidence, challenges, and directions. Annu Rev Public Health. 2005;26:341–365.

    Article  PubMed  Google Scholar 

  2. Galea S, Freudenberg N, Vlahov D. Cities and population health. Soc Sci Med. 2005;60:1017–1033.

    Article  PubMed  Google Scholar 

  3. Stanwell Smith R. The making of an epidemiologist: John Snow before the episode of the Broad Street pump. Commun Dis Public Health. 2002;5(4):269–270.

    PubMed  CAS  Google Scholar 

  4. Zenk S, Schulz AJ, Israel BA, James SA, Bao S, Wilson ML. Neighborhood racial composition, neighborhood poverty, and supermarket accessibility in metropolitan Detroit. Am J Public Health. 2005;95(4):660–667.

    Article  PubMed  Google Scholar 

  5. Schulz AJ, Northridge ME. Social determinants of health and environmental health promotion. Health Educ Behav. 2004;31(4):455–471.

    Article  PubMed  Google Scholar 

  6. Schulz AJ, Zenk S, Kannan S, Israel BA, Koch MA, Stokes C. Community-based participatory approach to survey design and implementation: the Healthy Environments Partnership Survey. In: Israel BA, Eng E, Schulz AJ, Parker E, eds. Methods for Conducting Community-Based Participatory Research for Health. San Francisco, California: Jossey-Bass; 2005:107–127.

    Google Scholar 

  7. Israel BA, Schurman SJ. Social support, control and the stress process. In: Glanz K, Lewis FM, Rimer BK, eds. Health Behavior and Health Education: Theory, Research and Practice. San Francisco, California: Jossey-Bass; 1990:187–215.

    Google Scholar 

  8. Kawachi I, Berkman LF. Social ties and mental health. J Urban Health. 2001;78(3):458–467.

    PubMed  CAS  Google Scholar 

  9. Schulz AJ, Kannan S, Dvonch JT, et al. Social and physical environments and disparities in risk for cardiovascular disease: the Healthy Environments Partnership conceptual model. Environ Health Perspec. 2005;113:1817–1825.

    Article  Google Scholar 

  10. Williams DR, Collins C. Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep. 2001;116:404–416.

    PubMed  CAS  Google Scholar 

  11. Wong MD, Shapiro MF, Boscardin WJ, Ettner SL. Contribution of major diseases to disparities in mortality. New Engl J Med. 2002;347(20):1585–1592.

    Article  PubMed  Google Scholar 

  12. Williams DR. Race, socioeconomic status and health. Ann N Y Acad Sci. 1999;896:173–188.

    Article  PubMed  CAS  Google Scholar 

  13. Cooper R, Cutler JA, Desvigne-Nickens P, et al. Trends and disparities in coronary heart disease, stroke and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention. Circulation. 2000;102(25):3137–3147.

    PubMed  CAS  Google Scholar 

  14. Hunt KJ, Resendez RG, Williams K, Haffner SM, Stern MP, Hazuda HP. All-cause and cardiovascular mortality among Mexican American and non-Hispanic white older participants in the San Antonio heart study—evidence against the “Hispanic paradox.” Am J Epidemiol. 2003;158(11):1048–1057.

    Article  PubMed  Google Scholar 

  15. Luepker RV. Cardiovascular disease among Mexican Americans [editorial]. Am J Med. 2001;110(2):147–148.

    Article  PubMed  CAS  Google Scholar 

  16. Pandey DK, Labarthe DR, Goff Jr. DC, Chan W, Nichaman MZ. Community-wide coronary heart disease mortality in Mexican Americans equals or exceeds that in non-Hispanic whites: the Corpus Christi Heart Project. Am J Med. 2001;110:81–87.

    Article  PubMed  CAS  Google Scholar 

  17. Sorlie PD, Backlund E, Johnson NJ, Rogot E. Mortality by Hispanic status in the United States. JAMA. 1993;270(20):2464–2468.

    Article  PubMed  CAS  Google Scholar 

  18. Sundquist J, Winkleby MA. Country of birth, acculturation status and abdominal obesity in a national sample of Mexican American women and men. Int J Epidemiol. 2000;29(3):470–477.

    Article  PubMed  CAS  Google Scholar 

  19. Winkleby MA, Robinson TN, Sundquist J, Kraemer HC. Ethnic variation in cardiovascular disease risk factors among children and young adults: findings from the Third National Health and Nutrition Examination Survey. JAMA. 1999;281(11):1006–1113.

    Article  PubMed  CAS  Google Scholar 

  20. Israel BA, Schurman SJ, House JS. Action research on occupational stress: involving workers as researchers. Int J Health Serv. 1989;19(1):135–155.

    PubMed  CAS  Google Scholar 

  21. Hugentobler MK, Israel BA, Schurman SJ. An action research approach to workplace health: integrating methods. Health Educ Q. 1992;19(1):55–76.

    PubMed  CAS  Google Scholar 

  22. Galea S, Schulz AJ. Methodologies for the study of urban health: how do we best assess how cities affect health? In Freudenberg N, Vlahov D, Galea S, eds. Cities and the Health of the Public. Nashville: Vanderbilt University Press; 2006; (in press).

  23. Zenk S, Schulz AJ, House JS, Benjamin A, Kannan S. Application of community-based participatory research in the design of an observational tool: the neighborhood observational checklist. In: Israel BA, Eng E, Schulz AJ, Parker E, eds. Methods in Community-Based Participatory Research for Health. San Francisco, California: Jossey-Bass; 2005:167–187.

    Google Scholar 

  24. Israel BA, Lichtenstein R, Lantz P, et al. The Detroit Community–Academic Urban Research Center: development, implementation and evaluation. J Public Health Manag Pract. 2001;7(5):1–19.

    PubMed  CAS  Google Scholar 

  25. Israel BA, Schulz AJ, Parker EA, Becker AB. Community-based participatory research: policy recommendations for promoting a partnership approach in health research. Educ Health. 2001;14(2):182–197.

    Article  CAS  Google Scholar 

  26. Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.

    Article  PubMed  CAS  Google Scholar 

  27. O'Fallon LR, Dearry A. Community-based participatory research as a tool to advance environmental health sciences. Environ Health Perspect. 2002;110(2):155–159.

    PubMed  Google Scholar 

  28. Farley R, Danziger S, Holzer HJ. Detroit Divided. New York: Russell Sage Foundation; 2000.

    Google Scholar 

  29. Sugrue TJ. The Origins of the Urban Crisis: Race and Inequality in Postwar Detroit. Princeton, New Jersey: Princeton University Press; 1996.

    Google Scholar 

  30. Schulz AJ, Williams DR, Israel BA, Lempert LB. Racial and spatial relations as fundamental determinants of health in Detroit. Milbank Q. 2002;80(4):677–707.

    Article  PubMed  Google Scholar 

  31. Glaeser EL, Vigdor JL. Racial Segregation in the 2000 Census: Promising News. Washington, District of Columbia: The Brookings Institution; 2001.

    Google Scholar 

  32. U.S. Census Bureau. U.S. Census 2000. 2000. Available at: http://www.census.gov/main/www/cen2000.html. Accessed June 2000.

  33. City of Detroit. Planning Report: The East Sector. Preliminary Draft 1984. Detroit: Planning Department; 1984.

    Google Scholar 

  34. City of Detroit. Cluster 5 Demographic Profile Based on 2000 Census. Detroit: Planning and Development Department; 2000.

    Google Scholar 

  35. Gerald R Ford School of Public Policy. Regional Solutions to Urban Revitalization: A Policy Forum on Alternative Locations for a Detroit Metro Park. 2004. Available at: http://www.fordschool.umich.edu/academics/IPE2004/riverfront.htm. Accessed October 7, 2005.

  36. Detroit News. Ambassador Bridge to Widen, Toll Roads. June 4, 2004. Available at: http://www.tollroadsnews.com/cgi-bin/a.cgi/k6zVkuf0EdiRW6r2jfFwDw. Accessed October 7, 2005.

  37. LeClere FB, Rogers RG, Peters K. Neighborhood social context and racial differences in women's disease mortality. J Health Soc Behav. 1998;39(2):91–107.

    Article  PubMed  CAS  Google Scholar 

  38. Ellen IG, Mijanovich T, Dillman K-N. Neighborhood effects on health: exploring the links and assessing the evidence. J Urban Aff. 2001;23(3–4):391–408.

    Article  Google Scholar 

  39. Pickett KE, Pearl M. Multilevel analyses of neighborhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health. 2001;55(2):111–122.

    Article  PubMed  CAS  Google Scholar 

  40. Waitzman NJ, Smith KR. Separate but lethal: the effects of economic segregation on mortality in metropolitan America. Milbank Q. 1998;76(3):341–373, 304.

    Article  PubMed  CAS  Google Scholar 

  41. Anderson RT, Sorlie PD, Backlund E, Johnson NJ, Kaplan GA. Mortality effects of community socioeconomic status. Epidemiology. 1997;8(1):42–47.

    Article  PubMed  CAS  Google Scholar 

  42. Diez-Roux AV, Nieto FJ. Epidemiology, clinical science and beyond. Epidemiology. 1997;8(4):459–461.

    PubMed  CAS  Google Scholar 

  43. Morland K, Wing S, Diez-Roux A, Poole C. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med. 2002;22(1):23–29.

    Article  PubMed  Google Scholar 

  44. Raudenbush SW. The quantitative assessment of neighborhood social environments. In: Kawachi I, Berkman L, eds. Neighborhoods and Health. Oxford University Press; 2003:112–131.

  45. Caughy MO, O'Campo PJ, Patterson J. A brief observational measure for urban neighborhoods. Health and Place. 2001;7(3):225–236.

    Article  PubMed  CAS  Google Scholar 

  46. McEwen BS. The End of Stress as We Know It. Washington, District of Columbia: Joseph Henry; 2002.

    Google Scholar 

  47. Karasek RT, Baker D, Marxer F, Ahlbom A, Theorell T. Job decision latitude, job demands and cardiovascular disease: a prospective study of Swedish men. Am J Public Health. 1981;71(7):694–705.

    Article  PubMed  CAS  Google Scholar 

  48. Seeman TE, Singer BH, Rowe JW, Horwitz RI, McEwen BS. Price of adaptation-allostatic load and its health consequences: MacArthur studies of successful aging. Arch Intern Med. 1997;157(19):2259–2268.

    Article  PubMed  CAS  Google Scholar 

  49. Selye H. The Stress of Life. New York: McGraw-Hill; 1956.

    Google Scholar 

  50. French JRP, Kahn R. A programmatic approach to studying the industrial environment and mental health. J Soc Issues. 1962;18:1–48.

    Article  Google Scholar 

  51. House JS. Work Stress and Social Support. Reading, Massachusetts: Addison-Wesley; 1981.

    Google Scholar 

  52. Katz D, Kahn R. The Social Psychology of Organizations. 2nd ed. New York: Wiley; 1978.

    Google Scholar 

  53. Baker EA, Israel BA, Schurman SJ. The integrated model: implications for worksite health promotion and occupational health and safety practice. Health Educ Q. 1996;23(2):175–190.

    PubMed  CAS  Google Scholar 

  54. Israel BA, Checkoway BN, Schulz AJ, Zimmerman MA. Health education and community empowerment: conceptualizing and measuring perceptions of individual, organizational, and community control. Health Educ Q. 1994;21(2):149–170.

    PubMed  CAS  Google Scholar 

  55. Strauss A, Corbin J. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. 2nd ed. Thousand Oaks, California: Sage; 1998.

    Google Scholar 

  56. Williams DR, Yu Y, Jackson J, Anderson NB. Racial differences in physical and mental health: socioeconomic status, stress and discrimination. J Health Psychol. 1997;2(3):335–351.

    Article  Google Scholar 

  57. Morgan DL, Krueger RA. The Focus Group Kit. Thousand Oaks, California: Sage; 1997.

    Google Scholar 

  58. Denzin NK, Lincoln YS, (eds.). Handbook of Qualitative Research. 2nd ed. Thousand Oaks, California: Sage; 2000.

    Google Scholar 

  59. Schulz AJ, Parker EA, Israel BA, Becker AB, Maciak BJ, Hollis R. Conducting a participatory community-based survey: collecting and interpreting data for a community health intervention on Detroit's east side. J Public Health Manag Pract. 1998;4(2):10–24.

    PubMed  CAS  Google Scholar 

  60. Israel BA, Farquhar SA, Schulz AJ, James SA, Parker EA. The relationship between social support, stress and health among women on Detroit's east side. Health Educ Behav. 2002;29(3):342–360.

    PubMed  Google Scholar 

  61. Schulz AJ, Parker EA, Israel BA, DeCarlo M, Lockett M. Addressing social determinants of health through community-based participatory research: the East Side Village Health Worker Partnership. Health Educ Behav. 2002;29(3):326–341.

    Article  PubMed  Google Scholar 

  62. Schulz AJ, Israel BA, Parker EA, Lockett M, Hill Y, Wills R. The East Side Village Health Worker Partnership: integrating research with action to reduce health disparities. Public Health Rep. 2001;116(6):548–557.

    PubMed  CAS  Google Scholar 

  63. Kieffer EC, Salabarría-Peña Y, Odoms-Young A, Willis S, Baber K, Guzman JR. The application of focus group methodologies to community-based participatory research. In: Israel BA, Eng E, Schulz AJ, Parker E, eds. Methods in Community-Based Participatory Research for Health. San Francisco, California: Jossey-Bass; 2005:146–166.

    Google Scholar 

  64. Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago: Aldine; 1967.

    Google Scholar 

  65. Caldwell CH, Zimmerman MA, Bernat DH, Sellers RM, Notaro PC. Racial identity, maternal support, and psychological distress among African American adolescents. Child Dev. 2002;73(4):1322–1336.

    Article  PubMed  Google Scholar 

  66. Sellers RM, Caldwell CH, Schmelke-Cone KH, Zimmerman MA. Racial identity, racial discrimination, perceived stress, and psychological distress among African American young adults. J Health Social Behav. 2003;44(3):302–317.

    Article  Google Scholar 

  67. Pardo MS. Mexican American Women as Activists: Identity and Resistance in Two Los Angeles Communities. Philadelphia: Temple University Press; 1998.

    Google Scholar 

  68. Farquhar S. Effects of the perceptions and observations of environmental stressors on health and well-being in residents of eastside and southwest Detroit, Michigan [Doctoral Dissertation]. Ann Arbor, Michigan: School of Public Health, University of Michigan; 2000.

  69. Sampson RJ, Raudenbush SW, Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science. 1997;277(5328):918–924.

    Article  PubMed  CAS  Google Scholar 

  70. Strogatz DS, James SA. Social support and hypertension among blacks and whites in a rural, southern community. Am J Epidemiol. 1986;124(6):949–956.

    PubMed  CAS  Google Scholar 

  71. Pargament KI, Koenig HG, Perez L. The many methods of religious coping: development and initial validation of the RCOPE. J Clin Psychol. 2000;56(4):519–543.

    Article  PubMed  CAS  Google Scholar 

  72. Parker EA, Lichtenstein RL, Schulz AJ, et al. Disentangling measures of individual perceptions of community social dynamics: results of a community survey. Health Educ Behav. 2001;28(4):462–486.

    Article  PubMed  CAS  Google Scholar 

  73. Centers for Disease Control. Behavioral risk factor surveillance system survey questionnaire. 1994. Available at: http://www.cdc.gpv/brfss/questionnaires/english.htm.

  74. Centers for Disease Control and Prevention. The National Health and Nutrition Examination Survey Questionnaire. 1999. Available at: http://www.cdc.gov/nceh/dls/nhanes.htm. Accessed June 8, 2004.

  75. Wittchen H-U. Reliability and validity studies of the WHO composite international diagnostic interview (CIDI): a critical review. J Psychiatr Res. 1994;28(1):57–84.

    Article  PubMed  CAS  Google Scholar 

  76. World Health Organization. International Classification of Diseases (ICD-10). Geneva: WHO; 1991.

    Google Scholar 

Download references

Acknowledgements

The Healthy Environments Partnership (www.hepdetroit.org) is a project of the Detroit Community-Academic Urban Research Center (www.sph.umich.edu/urc). We thank the members of the HEP Steering Committee for their contributions to the work presented here, including representatives from Boulevard Harambee, Brightmoor Community Center, Detroit Department of Health and Wellness Promotion, Detroit Hispanic Development Corporation, Friends of Parkside, Henry Ford Health System, Southwest Detroit Environmental Vision, Southwest Solutions, University of Detroit Mercy, and the University of Michigan Schools of Public Health, Nursing and Social Work and Survey Research Center. HEP is funded by the National Institute of Environmental Health Sciences (NIEHS), #R01 ES10936. The results presented here are solely the responsibility of the authors and do not necessarily represent the views of NIEHS. Finally, we thank Sue Andersen for her assistance with the preparation of this manuscript.

Author information

Authors and Affiliations

  1. University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI, 48109-2029, USA

    Barbara A. Israel PH, MPH

Authors
  1. Barbara A. Israel PH, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amy J. Schulz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lorena Estrada-Martinez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shannon N. Zenk
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Edna Viruell-Fuentes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonia M. Villarruel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carmen Stokes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara A. Israel PH, MPH.

Additional information

Israel, Schulz, and Estrada-Martinez are with the University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI 48109-2029, USA; Zenk is with the University of Illinois, Chicago, IL, USA; Viruell-Fuentes is with the Harvard School of Public Health, Boston, MA, USA; Villarruel is with the University of Michigan School of Nursing, Ann Arbor, MI, USA; Stokes is with the University of Detroit-Mercy, Detroit, MI, USA.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Israel, B.A., Schulz, A.J., Estrada-Martinez, L. et al. Engaging Urban Residents in Assessing Neighborhood Environments and Their Implications for Health. JURH 83, 523–539 (2006). https://doi.org/10.1007/s11524-006-9053-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-006-9053-6

Keywords

Search

Navigation