Terrence D. Hill

Neighborhood disorder, psychophysiological distress, and health

How do neighborhoods affect the health of residents? We propose that the impact of neighborhood disorder on self-reported health is mediated by psychological and physiological distress. We hypothesize a stress process in which chronic stressors in the environment give rise to a psychological and physiological stress response that ultimately affects health. The exogenous variable of interest is the neighborhood where disadvantaged persons live, which may expose them to chronic stressors in the form of crime, trouble, harassment, and other potentially distressing signs of disorder and decay. The mediator is the stress response that occurs in the body and brain. Of interest here is a psychological stress response in the form of fearful anxiety and depression, and a physiological stress response in the form of signs and symptoms of autonomic arousal, such as dizziness, chest pains, trouble breathing, nausea, upset stomach, and weakness. The outcome is poor health. This model is supported using data from the Welfare, Children, and Families project, a sample of 2,402 disadvantaged women in disadvantaged neighborhoods in Chicago, Boston, and San Antonio.

An examination of processes linking perceived neighborhood disorder and obesity

In this paper, we use data collected from a statewide probability sample of Texas, USA adults to test whether perceptions of neighborhood disorder are associated with increased risk of obesity. Building on prior research, we also test whether the association between neighborhood disorder and obesity is mediated by psychological, physiological, and behavioral mechanisms. We propose and test a theoretical model which suggests that psychological distress is a lynchpin mechanism that links neighborhood disorder with obesity risk through chronic activation of the physiological stress response, poor self-rated overall diet quality, and irregular exercise. The results of our analyses are generally consistent with this theoretical model. We find that neighborhood disorder is associated with increased risk of obesity, and this association is entirely mediated by psychological distress. We also observe that the positive association between psychological distress and obesity is fully mediated by physiological distress and poor self-rated overall diet quality and only partially mediated by irregular exercise.

Neighborhood disorder, sleep quality, and psychological distress: Testing a model of structural amplification

Using data from the 2004 Survey of Texas Adults (n=1504), we examine the association between perceived neighborhood disorder and psychological distress. Building on previous research, we test whether the effect of neighborhood disorder is mediated and moderated by sleep quality. Our specific analytic strategy follows a two-stage theoretical model of structural amplification. In the first stage, perceptions of neighborhood disorder increase psychological distress indirectly by reducing sleep quality. In the second stage, the effect of neighborhood disorder on psychological distress is amplified by poor sleep quality. The results of our analyses are generally consistent with our theoretical model. We find that neighborhood disorder is associated with poorer sleep quality and greater psychological distress. We also observe that the positive association between neighborhood disorder and psychological distress is mediated (partially) and moderated (amplified) by poor sleep quality.

Does sleep quality mediate the association between neighborhood disorder and self-rated physical health?

OBJECTIVES We examine the association between perceived neighborhood disorder and self-rated physical health. Building on previous research, we test whether this association is mediated by sleep quality. METHODS We use data from the 2004 Survey of Texas Adults (n=1323) to estimate a series of ordinary least squares regression models. We formally assess mediation by testing for significant changes in the effect of neighborhood disorder before and after adjusting for sleep quality. RESULTS We find that residence in a neighborhood that is perceived as noisy, unclean, and crime-ridden is associated with poorer self-rated physical health, even with controls for irregular exercise, poor diet quality, smoking, binge drinking, obesity and a host of relevant sociodemographic factors. Our results also indicate that the relationship between neighborhood disorder and self-rated physical health is partially mediated by lower sleep quality. CONCLUSION Targeted interventions designed to promote sleep quality in disadvantaged neighborhoods may help to improve the physical health of residents in the short-term. Policies aimed at solving the problem of neighborhood disorder are needed to support sleep quality and physical health in the long-term.

Perceived neighborhood quality, sleep quality, and health status: Evidence from the Survey of the Health of Wisconsin

Why does living in a disadvantaged neighborhood predict poorer mental and physical health? Recent research focusing on the Southwestern United States suggests that disadvantaged neighborhoods favor poor health, in part, because they undermine sleep quality. Building on previous research, we test whether this process extends to the Midwestern United States. Specifically, we use cross-sectional data from the Survey of the Health of Wisconsin (SHOW), a statewide probability sample of Wisconsin adults, to examine whether associations among perceived neighborhood quality (e.g., perceptions of crime, litter, and pleasantness in the neighborhood) and health status (overall self-rated health and depression) are mediated by overall sleep quality (measured as self-rated sleep quality and physician diagnosis of sleep apnea). We find that perceptions of low neighborhood quality are associated with poorer self-rated sleep quality, poorer self-rated health, and more depressive symptoms. We also observe that poorer self-rated sleep quality is associated with poorer self-rated health and more depressive symptoms. Our mediation analyses indicate that self-rated sleep quality partially mediates the link between perceived neighborhood quality and health status. Specifically, self-rated sleep quality explains approximately 20% of the association between neighborhood quality and self-rated health and nearly 19% of the association between neighborhood quality and depression. Taken together, these results confirm previous research and extend the generalizability of the indirect effect of perceived neighborhood context on health status through sleep quality.

Religiosity and Adolescent Substance Use: Evidence From the National Survey on Drug Use and Health

Prior research indicates that religiosity is associated with lower levels of substance use in adolescence. The extant research, however, is limited by issues related to data quality and analytic strategy. The current research uses the National Survey on Drug Use and Health to further our understanding of the nature of the relationship between religiosity and substance use during adolescence. Results show that religiosity reduces the odds of tobacco use, heavy drinking, prescription drug misuse, marijuana use, and other illicit drug use. These associations are partially explained by respondent and peer attitudes toward substance use and, to a lesser extent, respondent psychological well-being. The influence of respondent substance use attitude is especially pronounced, explaining between 41% (marijuana) and 53% (tobacco) of the association between religiosity and substance use. In fully adjusted models, all mediators account for between 46% (marijuana) and 59% (tobacco) of the association between religiosity and substance use.

Social demands, social supports, and psychological distress among low-income women

We investigate the association between social demands and psychological distress among low-income women. We argue that perceptions of excessive social demands can be psychologically distressing and examine the extent to which social demands predict psychological distress over 2 years. Our results reveal several important patterns. First, emotional, but not instrumental, demands are positively associated with psychological distress. Second, emotional and instrumental supports are more strongly associated with psychological distress than are emotional demands. Third, emotional support buffers the adverse effects of emotional demands. Finally, other chronic stressors, including economic hardship, neighborhood problems, and household disrepair, are more strongly associated with psychological distress than are social demands.

Religious involvement and healthy lifestyles: Evidence from the survey of Texas adults

Background: Although research shows that religious involvement is associated with a wide range of individual health behaviors, it has yet to be determined whether the effect of religious involvement extends to an overall pattern of regular health practices that may constitute a lifestyle.Purpose: Building on prior research, we test whether religious individuals tend to engage in healthier lifestyles than individuals who are less religious.Methods: Using data collected from a statewide probability sample of 1,369 Texas adults, we estimate a series of ordinary least squares regression models to assess the net effect of religious involvement on overall healthy lifestyle scores.Results: The results of our study indicate that religious individuals do tend to engage in healthier lifestyles, and this pattern is similar for men and women and across race/ethnic groups. We also find some evidence to suggest that the association between religious involvement and healthy lifestyles may be less pronounced in old age.Conclusions: Assuming that religious involvement is associated with healthier lifestyles, additional research is needed to account for these patterns. Future studies should also consider whether healthy lifestyles may serve as a mechanism through which religious involvement might favor health and longevity.

Victimization in Early Life and Mental Health in Adulthood: An Examination of the Mediating and Moderating Influences of Psychosocial Resources.

Although numerous studies have documented the long-term effects of childhood victimization on mental health in adulthood, few have directly examined potential mediators and moderators of this association. Using data from the Welfare, Children, and Families project (1999)—a probability sample of 2,402 predominantly black and Hispanic low-income women with children living in Boston, Chicago, and San Antonio—we predict psychological distress in adulthood with measures of physical assault and sexual coercion before age 18. Building on previous research, we test the mediating and moderating influences of emotional support, instrumental support, and self-esteem. Although we observe no indirect effects of physical assault, the effect of sexual coercion is partially mediated by instrumental support and self-esteem. We also find that the effects of physical assault and sexual coercion are moderated (buffered) by emotional support and self-esteem.

Religious Attendance and Loneliness in Later Life

PURPOSE OF THE STUDY Studies show that loneliness is a major risk factor for health issues in later life. Although research suggests that religious involvement can protect against loneliness, explanations for this general pattern are underdeveloped and undertested. In this paper, we propose and test a theoretical model, which suggests that social integration and social support are key mechanisms that link religious attendance and loneliness. DESIGN AND METHODS To formally test our theoretical model, we use data from the National Social Life Health and Aging Project (2005/2006), a large national probability sample of older adults aged 57-85 years. RESULTS We find that religious attendance is associated with higher levels of social integration and social support and that social integration and social support are associated with lower levels of loneliness. A series of mediation tests confirm our theoretical model. IMPLICATIONS Taken together, our results suggest that involvement in religious institutions may protect against loneliness in later life by integrating older adults into larger and more supportive social networks. Future research should test whether these processes are valid across theoretically relevant subgroups.