Neighborhood effects on health: Exploring the links and assessing the evidence

This article explores the possible causal pathways through which neighborho ods might affect health and then reviews the existing evidence. Although me thodological issues make the literature inconclusive, the authors offer a p rovisional hypothesis for how neighborhoods shape health outcomes. They hyp othesize that neighborhoods may primarily influence health in two ways: fir st, through relatively short-term influences on behaviors, attitudes, and h ealth-care utilization, thereby affecting health conditions that are most i mmediately responsive to such influences; and second through a longer-term process of "weathering," whereby the accumulated stress, lower environmenta l quality, and limited resources of poorer communities, experienced over ma ny years, erodes the health of residents in ways that make them more vulner able to mortality from any given disease. Finally, drawing on the more exte nsive research that has been done exploring the effects of neighborhoods on education and employment, the authors suggest several directions for futur e research.