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Linking perceptions of neighbourhood to health in Hamilton, Canada
  1. K Wilson1,2,
  2. S Elliott2,3,
  3. M Law2,
  4. J Eyles2,3,
  5. M Jerrett2,3,
  6. S Keller-Olaman2
  1. 1Department of Geography, University of Toronto at Mississauga, Mississauga, Ontario, Canada
  2. 2McMaster Institute of Environment and Health, McMaster University, Hamilton, Ontario, Canada
  3. 3School of Geography and Geology, McMaster University
  1. Correspondence to:
 Professor K Wilson
 University of Toronto, Department of Geography University of Toronto at Mississauga, 3359 Mississauga Road N, Mississauga, Ontario, Canada L5L 1C6;


Study objective: To investigate the association between perceptions of neighbourhood physical and social characteristics and three health outcomes (self assessed health status, chronic conditions, and emotional distress).

Design: Cross sectional survey data analysed in small neighbourhoods.

Setting: Hamilton, Ontario, Canada, a medium sized industrial city, located at the western end of Lake Ontario (population at the time of the study about 380 000).

Participants: Random sample of 1504 adults aged 18 years and older residing in four contrasting neighbourhoods.

Main results: Significant differences across the four neighbourhoods are apparent in self assessed health status and emotional distress, but not in chronic conditions. Neighbourhoods with lower SES reported poorer health and more emotional distress. Perceptions of the physical environment dominated social concerns in all neighbourhoods. For all three health outcomes, individual risk factors followed expectations, with measures of poverty, age, and lifestyle all significantly associated with poor health outcomes. Physical environmental problems were positively and significantly associated with poor physical and emotional health. Specifically, people reporting they dislike aspects of their neighbourhood’s physical environment are 1.5 times more likely to report chronic health conditions (OR 1.56, 95% CI 1.19 to 2.05), while those reporting physical likes with their neighbourhood are less likely to report fair/poor health (OR 0.50, 95% CI 0.28 to 0.90) or emotional distress (OR 0.45, 95% CI 0.26 to 0.80).

Conclusions: These results demonstrate the importance of neighbourhood perceptions as a determinant of health, as well as conventional factors such as low income, lifestyle, and age. The dominance of physical environmental concerns may have arisen from the industrial nature of Hamilton, but this result merits further investigation.

  • neighbourhood
  • health
  • environmental perceptions
  • SES, socioeconomic status
  • LISA, local indicators of spatial associations

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  • * Objective measures of neighbourhood environments may be important predictors of health, however, ambient air quality data (TSP and SO2) based on postal code data were included in supplementary analyses but were not significantly related to the health outcomes.

  • Funding: the authors gratefully acknowledge the Social Sciences and Humanities Research Council of Canada for funding under its Society, Culture and the Health of Canadians strategic area and other members of the research team. We also recognise the contributions of our community partners (Central West Health Planning Information Unit, De dwa da dehs nye>s Aboriginal Health Centre, Hamilton Community Care Access Centre, Hamilton District Health Council, Hamilton Social and Public Health Services, Social Planning and Research Council of Hamilton).

  • Conflicts of interest: none declared.

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