Blog & News
Neighborhood Support Matters for Child HealthNovember 22, 2022:
Where people live, work, and play has been shown to have important impacts on health. In addition to one’s physical environment (e.g., access to safe schools, parks, and sources of nutritious food), the extent to which people feel connected to a supportive community with a network of resources is an important factor for health. This concept is known as “social capital," and has been linked with a broad range of health outcomes including mortality.
Neighborhood support is a form of social capital that can be measured with available survey data. The National Survey of Children’s Health (NSCH) is nationally representative and includes children (age 0-17) in all 50 states and the District of Columbia. The data from this survey provide information on family perceptions of neighborhood support and a broad range of child sociodemographic and health characteristics. NSCH data also allow researchers to study the association between supportive neighborhoods and key children’s health outcomes.
Only about half (55%) of children lived in a supportive neighborhood. As shown in the figure below, the likelihood of living in a supportive neighborhood also varied across population subgroups. Perceived neighborhood support was less likely for non-English households, children of color, children with special health care needs (CSHCN), families with less education or income, and children with public health insurance coverage or who were uninsured.
Percent of children living in supportive neighborhoods, by child characteristics
Source: SHADAC analysis of the National Survey of Children’s Health, 2018-2019
We found that neighborhood support matters for a child’s health. Family perceptions of neighborhood support were significantly associated with four of the five outcomes we examined, after adjusting for child characteristics. Children in supportive neighborhoods were less likely to have a past year emergency department visit or unmet care needs and were more likely to have a preventive dental visit and better parent-reported oral health status (Table below).
|Past year ED visit odds ratio||Unmet health needs odds ratio||Preventive dental visit odds ratio||Fair/poor health odds ratio||Fair/poor oral health odds ratio|
Notes: *** p<0.001, ** p<0.01, * p<0.05 Unmet health care needs included medical, dental, hearing, vision, or mental health needs. All models were adjusted for demographic characteristics (age, sex, race/ethnicity, household language, income, parental education), children with special healthcare needs (based on a five-item screener), health insurance coverage, and a composite measure of family resilience. Resilience was defined by how families face problems, with ‘all of the time’ or ‘most of the time’ responses to four items: talk together, work together, draw on strengths, stay hopeful.
Our study provides evidence that neighborhood cohesion is correlated with better child health outcomes. Policies that support healthy neighborhoods and build social capital are essential for the wellbeing of children. This includes policies that benefit child development, such as neighborhood schools, playgrounds, and early childhood education. Community-based programs and health care also play a role in fostering neighborhood support by strengthening networks and linking community members to needed care and resources.
NSCH dataset provided by the Data Resource Center:
Child and Adolescent Health Measurement Initiative. 2018-2019 National Survey of Children’s Health (NSCH) Stata Constructed DataSet. Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement U59MC27866 from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved from www.childhealthdata.org.