title: The importance of social context: neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders.
abstract: This study examines the relationship among neighborhood stressors, stress-buffering mechanisms, and likelihood of alcohol, drug, and mental health (ADM) disorders in adults from 60 US communities (n=12,716). Research shows that larger support structures may interact with individual support factors to affect mental health, but few studies have explored buffering effects of these neighborhood characteristics. We test a conceptual model that explores effects of neighborhood stressors and stress-buffering mechanisms on ADM disorders. Using Health Care for Communities with census and other data, we found a lower likelihood of disorders in neighborhoods with a greater presence of stress-buffering mechanisms. Higher neighborhood average household occupancy and churches per capita were associated with a lower likelihood of disorders. Cross-level interactions revealed that violence-exposed individuals in high crime neighborhoods are vulnerable to depressive/anxiety disorders. Likewise, individuals with low social support in neighborhoods with high social isolation (i.e., low-average household occupancy) had a higher likelihood of disorders. If replicated by future studies using longitudinal data, our results have implications for policies and programs targeting neighborhoods to reduce ADM disorders.
authors.affiliation: UCLA Semel Institute Health Service Research Center, Los Angeles, CA, USA. sstockdale@mednet.ucla.edu
authors.forename: Susan E
authors.initials: SE
authors.lastname: Stockdale
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Wells
authors.forename: Lingqi
authors.initials: L
authors.lastname: Tang
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Belin
authors.forename: Lily
authors.initials: L
authors.lastname: Zhang
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Sherbourne
mesh_terms: D003415:Crime / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004777:Environment; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data; D012067:Religion; D012111:Residence Characteristics; D012944:Social Support; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000453:epidemiology*