Identifying Stress Landscapes in Boston Neighborhoods

Abstract

Purpose: Chronic stress plays a role in the development of health disparities. However, the relationship between neighborhood-stressors and stress-related health problems and behaviors is unknown. In the city of Boston MA, three neighborhoods, while within a three-mile radius, have widely divergent life expectancies. This work aims to investigate and compare perceived neighborhood-level stressors, stress-related negative behaviors, and stress-related health problems in these neighborhoods. Methods: 326 participants were surveyed from the neighborhoods. Participants were asked to rate 1) 27 neighborhood-stressors, 2) 16 stress-related negative behaviors and 3) 13 stress-related health problems using a 1-5 Likert scale. Differences in responses between neighborhoods were analyzed using Kruskal-Wallis (K-W) and chi-square tests. Results: The highest neighborhood-stressors overall were related to finance, unequal treatment, and unsafe bike/pedestrian access. The highest stress-related health problems were related to substance abuse and obesity and the largest stress-related behaviors were related to poor diet, intolerance, and aggressive driving. There were significant differences across neighborhoods (p<.05) for 18 out of 27 neighborhood stressors, 8 out of 10 stress-related health problems and 12 out of 15 stress-related behaviors. Conclusions: There is marked contrast in stress landscapes between the three neighborhoods in Boston despite their geographical proximity. This finding potentially serves as an explanation for the drastic differences in health outcomes, even though these neighborhoods are equidistant from academic medical centers. Strategies for improving the health of individuals should incorporate the unique stressors at the neighborhood level. Further research is needed to investigate how specifically neighborhood stressors influence the health of residents, thereby informing what policy interventions might be useful.