The association of neighbourhood psychosocial stressors and self-rated health in Amsterdam, The Netherlands.
OBJECTIVE
To investigate associations between neighbourhood-level psychosocial stressors (i.e. experience of crime, nuisance from neighbours, drug misuse, youngsters frequently hanging around, rubbish on the streets, feeling unsafe and dissatisfaction with the quality of green space) and self-rated health in Amsterdam, the Netherlands.


METHODS
A random sample of 2914 subjects aged > or = 18 years from 75 neighbourhoods in the city of Amsterdam, the Netherlands.


METHODS
Individual data from the Social State of Amsterdam Survey 2004 were linked to data on neighbourhood-level attributes from the Amsterdam Living and Security Survey 2003. Multilevel logistic regression was used to estimate odds ratios and neighbourhood-level variance.


RESULTS
Fair to poor self-rated health was significantly associated with neighbourhood-level psychosocial stressors: nuisance from neighbours, drug misuse, youngsters frequently hanging around, rubbish on the streets, feeling unsafe and dissatisfaction with green space. In addition, when all the neighbourhood-level psychosocial stressors were combined, individuals from neighbourhoods with a high score of psychosocial stressors were more likely than those from neighbourhoods with a low score to report fair to poor health. These associations remained after adjustments for individual-level factors (i.e. age, sex, educational level, income and ethnicity). The neighbourhood-level variance showed significant differences in self-rated health between neighbourhoods independent of individual-level demographic and socioeconomic factors.


CONCLUSIONS
Our findings show that neighbourhood-level psychosocial stressors are associated with self-rated health. Strategies that target these factors might prove a promising way to improve public health.
Agyemang
Charles
C
Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. c.o.agyemang@amc.uva.nl
van Hooijdonk
Carolien
C
Wendel-Vos
Wanda
W
Lindeman
Ellen
E
Stronks
Karien
K
Droomers
Mariël
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D003415:Crime; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D012111:Residence Characteristics; D012649:Self Concept; D012931:Social Environment; D013315:Stress, Psychological; D019966:Substance-Related Disorders; D014478:Unemployment; D014504:Urban Health