title: Perceived Neighborhood Safety During Adolescence Predicts Subsequent Deterioration of Subjective Health Two Decades Later; Gender Differences in a Racially-Diverse Sample.
abstract: BACKGROUND
  Current study aimed to investigate whether perceived neighborhood as unsafe during adolescence predicts the subsequent perceived health two decades later.
  
  
  METHODS
  In a prospective study of an ethnically diverse urban sample (83.2% Black), conducted from 1994 to 2012, 851 adolescents were enrolled at 9(th) grade. Three hundred and seventy-eight participants were followed from 9(th) grade for 18 years. The outcome was subjective health (feeling as healthy as other people of the same age) measured at baseline (mean age 15 years) and end of follow-up (mean age 33 years). The independent variable was neighborhood perceived as unsafe measured at 9(th) grade. Baseline age, family structure, and parental employment were control variables. We ran logistic regressions in the pooled sample and also specific to each gender.
  
  
  RESULTS
  Perceived neighborhood as unsafe at 9(th) grade predicted deterioration of subjective health over the next 18 years (unadjusted odds ratio = 1.742, 95% confidence interval = 1.042-2.911). This association remained significant in a multivariable model that controlled for baseline subjective health, family structure, and parental employment. The association between perceived neighborhood safety at 9(th) grade and subsequent deterioration of perceived health during the next 12 years was significant for females but not males.
  
  
  CONCLUSIONS
  Our findings suggest that perception of unsafe neighborhoods during adolescence has negative consequences years later for the health of females. Further research is needed to replicate the findings using objective measures of health.
authors.affiliation: Department of Psychiatry, and School of Medicine, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48105, USA; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
authors.forename: Shervin
authors.initials: S
authors.lastname: Assari
authors.affiliation: Department of Psychiatry, and School of Medicine, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48105, USA; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
authors.forename: Cleopatra Howard
authors.initials: CH
authors.lastname: Caldwell
authors.affiliation: Prevention Research Center, School of Public Health, University of Michigan, Washington Heights, Ann Arbor, MI 48109-2029, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Washington Heights, Ann Arbor, MI 48109-2029, USA.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Zimmerman
keywords: Adolescence; adults; life course; neighbourhood; subjective health