Rating neighborhoods for older adult health: results from the African American Health study.
BACKGROUND
Social theories suggest that neighborhood quality affects health. Observer ratings of neighborhoods should be subjected to psychometric tests.


METHODS
African American Health (AAH) study subjects were selected from two diverse St. Louis metropolitan catchment areas. Interviewers rated streets and block faces for 816 households. Items and a summary scale were compared across catchment areas and to the resident respondents' global neighborhood assessments.


RESULTS
Individual items and the scale were strongly associated with both the catchment area and respondent assessments. Ratings based on both block faces did not improve those based on a single block face. Substantial interviewer effects were observed despite strong discriminant and concurrent validity.


CONCLUSIONS
Observer ratings show promise in understanding the effect of neighborhood on health outcomes. The AAH Neighborhood Assessment Scale and other rating systems should be tested further in diverse settings.
Andresen
Elena M
EM
Department of Epidemiology and Biostatistics, College of Public Health and Health Professions, University of Florida Health Sciences Center, PO Box 100231 Gainesville, FL 32610, USA. andresen@phhp.ufl.edu
Malmstrom
Theodore K
TK
Wolinsky
Fredric D
FD
Schootman
Mario
M
Miller
J Philip
JP
Miller
Douglas K
DK
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008923:Missouri; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires