Neighborhood Influences on Health among Black and White Adults

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The current study examined the relationships among the neighborhood environment, levels of self-efficacy, health behaviors, and health outcomes among adults in the United States. The goals of the research were as follows: 1. To examine the role that health behaviors play in the relationship between neighborhood and health; 2. To determine whether health-related self-efficacy mediates or moderates the relationship between neighborhood and health behaviors; 3. To investigate potential gender, education, and race differences in the relationships among the constructs.

The study included 5,600 whites and 321 blacks who participated in the first wave of the National Survey of Midlife Development in the Unites States (MIDUS I). The age range of the sample was 20-75 (mean= 47.14 years) and roughly half of the participants were male (47.4%). Data on the neighborhood (including safety, physical conditions, social cohesion, and homeplace), health-related self-efficacy, health behaviors, and the health outcomes of self-rated health, obesity, and cardiovascular disease were collected through telephone interviews and self-report questionnaires.

Structural equation modeling was employed to address the research goals. The results showed that self-efficacy mediated the relationship between neighborhood and physical activity and that health behaviors mediated the path between neighborhood and physical activity. However, self-efficacy did not serve as a moderator in the association between neighborhood and physical activity. Demographic differences were found according to age, gender, race, and education. Specifically, the model was particularly salient for late midlife and older adults, females, and those with some college education. Furthermore, the impact of neighborhood factors on self-efficacy was greater for blacks than whites.

The present findings contribute to the literature by elucidating the interrelations among neighborhood and the individual-level factors of self-efficacy and physical activity in predicting health outcomes. Furthermore, the direct effect of physical activity on health outcomes suggests that physical activity engagement should be a particular area of intervention focus, especially among older adults and women. Future research should include objective measures of neighborhood, physical activity, and health, additional contexts such as the workplace, individuals above the age of 75, and greater representation of minority groups.





Bromell, Lea Raye (2011). Neighborhood Influences on Health among Black and White Adults. Dissertation, Duke University. Retrieved from


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