Individual health care system distrust and neighborhood social environment

How are they jointly associated with self-rated health?

Tse Chuan Yang, Stephen Augustus Matthews, Carla Shoff

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Americans' distrust in the health care system has increased in the past decades; however, little research has explored the impact of distrust on self-rated health and even less is known about whether neighborhood social environment plays a role in understanding the relationship between distrust and self-rated health. This study fills these gaps by investigating both the direct and moderating associations of neighborhood social environment with self-rated health. Our analysis is based on the 2008 Philadelphia Health Management Corporation's household survey and neighborhood-level data. Findings from multilevel logistic regression show that after controlling for individual- and neighborhood-level covariates, distrust is directly and adversely related to self-rated health, and that neighborhood social affluence and stability are directly and negatively associated with the odds of reporting poor/fair health. Neighborhood disadvantage and crime rates are not directly related to self-rated health, but increase the odds of having poor/fair health via distrust. Overall, our results suggest that macro-level actions can alter individual's perception of residential environment and lead to improved health. To improve the public health in an urban setting, rebuilding confidence in the health care system is integral, and the policies that help establish safe and cohesive neighborhoods may reduce the adverse effect of distrust on self-rated health.

Original languageEnglish (US)
Pages (from-to)945-958
Number of pages14
JournalJournal of Urban Health
Volume88
Issue number5
DOIs
StatePublished - Oct 1 2011

Fingerprint

Social Environment
health care
Delivery of Health Care
Health
health
Health Fairs
residential environment
affluence
Crime
crime rate
household survey
macro level
health promotion
Public Health
Logistic Models
corporation
public health
confidence
logistics
regression

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Medicine(all)

Cite this

@article{60e29e692d104cb5b95a67f9f82f7fc1,
title = "Individual health care system distrust and neighborhood social environment: How are they jointly associated with self-rated health?",
abstract = "Americans' distrust in the health care system has increased in the past decades; however, little research has explored the impact of distrust on self-rated health and even less is known about whether neighborhood social environment plays a role in understanding the relationship between distrust and self-rated health. This study fills these gaps by investigating both the direct and moderating associations of neighborhood social environment with self-rated health. Our analysis is based on the 2008 Philadelphia Health Management Corporation's household survey and neighborhood-level data. Findings from multilevel logistic regression show that after controlling for individual- and neighborhood-level covariates, distrust is directly and adversely related to self-rated health, and that neighborhood social affluence and stability are directly and negatively associated with the odds of reporting poor/fair health. Neighborhood disadvantage and crime rates are not directly related to self-rated health, but increase the odds of having poor/fair health via distrust. Overall, our results suggest that macro-level actions can alter individual's perception of residential environment and lead to improved health. To improve the public health in an urban setting, rebuilding confidence in the health care system is integral, and the policies that help establish safe and cohesive neighborhoods may reduce the adverse effect of distrust on self-rated health.",
author = "Yang, {Tse Chuan} and Matthews, {Stephen Augustus} and Carla Shoff",
year = "2011",
month = "10",
day = "1",
doi = "10.1007/s11524-011-9561-x",
language = "English (US)",
volume = "88",
pages = "945--958",
journal = "Journal of Urban Health",
issn = "1099-3460",
publisher = "Springer Science and Business Media Deutschland GmbH",
number = "5",

}

Individual health care system distrust and neighborhood social environment : How are they jointly associated with self-rated health? / Yang, Tse Chuan; Matthews, Stephen Augustus; Shoff, Carla.

In: Journal of Urban Health, Vol. 88, No. 5, 01.10.2011, p. 945-958.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Individual health care system distrust and neighborhood social environment

T2 - How are they jointly associated with self-rated health?

AU - Yang, Tse Chuan

AU - Matthews, Stephen Augustus

AU - Shoff, Carla

PY - 2011/10/1

Y1 - 2011/10/1

N2 - Americans' distrust in the health care system has increased in the past decades; however, little research has explored the impact of distrust on self-rated health and even less is known about whether neighborhood social environment plays a role in understanding the relationship between distrust and self-rated health. This study fills these gaps by investigating both the direct and moderating associations of neighborhood social environment with self-rated health. Our analysis is based on the 2008 Philadelphia Health Management Corporation's household survey and neighborhood-level data. Findings from multilevel logistic regression show that after controlling for individual- and neighborhood-level covariates, distrust is directly and adversely related to self-rated health, and that neighborhood social affluence and stability are directly and negatively associated with the odds of reporting poor/fair health. Neighborhood disadvantage and crime rates are not directly related to self-rated health, but increase the odds of having poor/fair health via distrust. Overall, our results suggest that macro-level actions can alter individual's perception of residential environment and lead to improved health. To improve the public health in an urban setting, rebuilding confidence in the health care system is integral, and the policies that help establish safe and cohesive neighborhoods may reduce the adverse effect of distrust on self-rated health.

AB - Americans' distrust in the health care system has increased in the past decades; however, little research has explored the impact of distrust on self-rated health and even less is known about whether neighborhood social environment plays a role in understanding the relationship between distrust and self-rated health. This study fills these gaps by investigating both the direct and moderating associations of neighborhood social environment with self-rated health. Our analysis is based on the 2008 Philadelphia Health Management Corporation's household survey and neighborhood-level data. Findings from multilevel logistic regression show that after controlling for individual- and neighborhood-level covariates, distrust is directly and adversely related to self-rated health, and that neighborhood social affluence and stability are directly and negatively associated with the odds of reporting poor/fair health. Neighborhood disadvantage and crime rates are not directly related to self-rated health, but increase the odds of having poor/fair health via distrust. Overall, our results suggest that macro-level actions can alter individual's perception of residential environment and lead to improved health. To improve the public health in an urban setting, rebuilding confidence in the health care system is integral, and the policies that help establish safe and cohesive neighborhoods may reduce the adverse effect of distrust on self-rated health.

UR - http://www.scopus.com/inward/record.url?scp=84855337654&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84855337654&partnerID=8YFLogxK

U2 - 10.1007/s11524-011-9561-x

DO - 10.1007/s11524-011-9561-x

M3 - Article

VL - 88

SP - 945

EP - 958

JO - Journal of Urban Health

JF - Journal of Urban Health

SN - 1099-3460

IS - 5

ER -