Self-rated health and its association with perceived environmental hazards, the social environment, and cultural stressors in an environmental justice population

Judy Y. Ou, Junenette L. Peters, Jonathan I. Levy, Roseann Bongiovanni, Alina Rossini, Madeleine K. Scammell

Communities with large minority populations often are located near sources of pollution and have higher crime rates, which may work in combination with other factors to influence health. Poor self-rated health is related to chronic health conditions and premature mortality, with minority populations most likely to report poor health. To address how both resident perception of neighborhood environments and chronic health conditions individually and collectively influence health, we examined self-rated health and its association with multiple types of perceived environmental hazards in a majority-Hispanic urban population. We conducted interviews with 354 residents of Chelsea, Massachusetts, US and asked about self-rated health, perceptions of their neighborhood, including participant-reported environmental hazards (e.g., air quality, odors and noise), aspects of the social environment (e.g., feeling safe, neighborhood crime, social cohesion), and culture-related stressors (e.g., immigration status, language stress, ethnic identity). Log-linear models examined the independent and multivariable associations between these factors and fair/poor self-rated health, controlling for socio-demographic characteristics and preexisting health conditions. Forty-one percent of participants reported fair/poor self-rated health. Participants frequently perceived environmental hazards such as problems with pests and regular noise disturbance as well as feeling unsafe. In a multivariable model, a greater number of reported noise disturbances (≥ 2 noise sources = 1.53 [1.04-2.26]) and reported insecurity with immigration status (1.66 [1.01-2.73]) were positively associated with fair/poor self-rated health. High social cohesion was inversely associated (0.74 [0.48-1.14]) with fair/poor self-rated health in the multivariable model. Negative perceptions of environmental hazards and reported cultural stressors were significantly associated with fair/poor self-rated health among residents in a low-income majority-minority community, with social cohesion having a beneficial association with self-rated health. Efforts to improve health should recognize the importance of public perceptions of social and environmental hazards found in neighborhood environments, and benefits of strengthening community connections.