Dr. Shreffler has received consultancy fees, speaking fees, and/or honoraria (less than $10,000) from the NIH Patient-Reported Outcomes Measurement Information System Assessment Center Usability Meeting.
Environment and Arthritis
Associations of perceived neighborhood environment on health status outcomes in persons with arthritis
Article first published online: 2 JUN 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 11, pages 1602–1611, November 2010
How to Cite
Martin, K. R., Shreffler, J., Schoster, B. and Callahan, L. F. (2010), Associations of perceived neighborhood environment on health status outcomes in persons with arthritis. Arthritis Care Res, 62: 1602–1611. doi: 10.1002/acr.20267
- Issue published online: 2 NOV 2010
- Article first published online: 2 JUN 2010
- Manuscript Accepted: 24 MAY 2010
- Manuscript Received: 12 MAR 2010
- National Institute of Arthritis and Musculoskeletal and Skin Diseases Multidisciplinary Clinical Research Center, Rheumatic Diseases. Grant Number: P60-AR49465-01
- Thurston Arthritis Research Center Training grant. Grant Number: 5T32-AR007416
To examine the association between 4 aspects of perceived neighborhood environment (aesthetics, walkability, safety, and social cohesion) and health status outcomes in a cohort of North Carolinians with self-reported arthritis after adjustment for individual and neighborhood socioeconomic status covariates.
In a telephone survey, 696 participants self-reported ≥1 types of arthritis or rheumatic conditions. Outcomes measured were physical and mental functioning (Short Form 12 health survey version 2 physical component and mental component summary [MCS]), functional disability (Health Assessment Questionnaire), and depressive symptomatology (Center for Epidemiologic Studies Depression Scale scores <16 versus ≥16). Multivariate regression and multivariate logistic regression analyses were conducted using Stata, version 11.
Results from separate adjusted models indicated that measures of associations for perceived neighborhood characteristics were statistically significant (P ≤ 0.001 to P = 0.017) for each health status outcome (except walkability and MCS) after adjusting for covariates. Final adjusted models included all 4 perceived neighborhood characteristics simultaneously. A 1-point increase in perceiving worse neighborhood aesthetics predicted lower mental health (B = −1.81, P = 0.034). Individuals had increased odds of depressive symptoms if they perceived lower neighborhood safety (odds ratio [OR] 1.36, 95% confidence interval [95% CI] 1.04–1.78; P = 0.023) and lower neighborhood social cohesion (OR 1.42, 95% CI 1.03–1.96; P = 0.030).
Study findings indicate that an individual's perception of neighborhood environment characteristics, especially aesthetics, safety, and social cohesion, is predictive of health outcomes among adults with self-reported arthritis, even after adjusting for key variables. Future studies interested in examining the role that community characteristics play on disability and mental health in individuals with arthritis might consider further examination of perceived neighborhood environment.