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Neighbourhood effects on health: Does it matter where you draw the boundaries?
Abstract
There has been considerable discussion in health geography and related areas of neighbourhood effects on health: the idea that people's health in one geographical area may be influenced not only by the composition of that area's population, but also by the area's geographical context. Hence, the healthiness or otherwise of the neighbourhood may have an important effect on local people's health. Although neighbourhoods and their boundaries are sometimes obvious to local residents, it is more common to find considerable disagreement on the size and contents of a neighbourhood. In this paper, we use British census Enumeration Districts as building blocks to construct alternative zonal systems, and experiment to see if neighbourhoods defined in different ways have similar implications for health. The well known modifiable areal unit problem shows that analytical conclusions may differ substantially according to how data are aggregated. Boundaries can be drawn to maximize equality of size, compactness of shape, homogeneity in social composition, accordance with 'natural' boundaries, and probably many other factors; which of these criteria are more effective in defining zones relevant to health? One conclusion is that the effect of neighbourhood conditions should be looked at using several different ways to define neighbourhoods, and that the size and composition of these neighbourhoods may be different in different parts of a study area.
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“the HIV/AIDS pandemic, which was observed to first affect relatively wealthy individuals until they quickly took up effective health interventions, which inverted its concentration to poor and marginalized populations [59].”
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Metadata
- Authors
- Flowerdew, R., Manley, D. J., & Sabel, C. E.
- Affiliations
- University of St Andrews (GB)
- Imperial College London (GB)
- Corresponding author
- Flowerdew, Robin
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2008-03
- Volume
- 66
- Issue
- 6
- Pages
- 1241-1255
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W1967823327
- Cited by
- 331
- References
- 0
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 14 · 2023: 13 · 2022: 15 · 2021: 20 · 2020: 19 · 2019: 22 · 2018: 20 · 2017: 17 · 2016: 34 · 2015: 17 · 2014: 25 · 2013: 26 · 2012: 21
- FWCI
- 17.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Explore Bristol Research (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- Joint Information Systems Committee
- Economic and Social Research Council
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Urban, Neighborhood, and Segregation Studies
- Social Sciences › Transportation › Urban Transport and Accessibility
- Keywords
- neighbourhood boundaries, modifiable areal unit problem, spatial aggregation, neighborhood composition, geographic context, health disparities
- MeSH terms
- Data Collection, Data Interpretation, Statistical, Environment, Geography, United Kingdom, Health Services Accessibility, Health Status, Humans, Residence Characteristics, Socioeconomic Factors, Small-Area Analysis, Censuses
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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