Health and the neighbourhood Processes and changes in the neighbourhood and the impact on health

The aim of this thesis was to contribute to the evidence base for the relation between the neighbourhood environment and the health of residents. In the general introduction, three main objectives were presented. The first was to better assess causal inference by studying the health impact of changing neighbourhood features. The second objective was to study the health impact of connected and interacting neighbourhood processes. The third objective was to investigate for which population groups and under which circumstances the neighbourhood environment is most relevant for health.
The research described in this thesis adds to the accumulating evidence that the neighbourhood environment influences health. Changes in several social neighbourhood characteristics were found to be associated with health. These results provide additional support for the existence of a causal relationship between perceived neighbourhood safety and social cohesion on the one hand, and health on the other. This thesis further showed that deteriorating neighbourhood characteristics seem to influence self-rated general health sooner than improving neighbourhood features. Furthermore, it is important to examine interrelated neighbourhood characteristics and processes simultaneously. Neighbourhood processes occur simultaneously and these processes can reinforce or obstruct each other’s impact on health. Considering these concurrent neighbourhood processes when studying the associations with health prevents that incorrect conclusions are drawn about the relevance of specific neighbourhood characteristics for health. Finally, we found some evidence that characteristics of the residents as well as the neighbourhood context influence the health impact of the neighbourhood environment. Neighbourhood green space was not found to have an overall impact on health. However, zooming in on a highly urbanised context and low socioeconomic groups, revealed that neighbourhood green space was related to health.