Effects of the perceptions and observations of environmental stressors on health and well-being in residents of eastside and southwest Detroit, Michigan.

摘要

Environmental stressors have been linked to negative physical and mental health outcomes. Moreover, environmental stressors and subsequent negative health outcomes are disproportionately distributed across society, with low-income populations and communities of color bearing most of the burden of exposure.A community-based participatory research approach was used to examine the association between the physical environment and the well-being of residents in eastside and southwest Detroit, Michigan. In addition, the association between perceived and observed environmental stressors was examined to better understand how residents perceive environmental problems in their neighborhoods. Quantitative data were collected using an observational environmental checklist that recorded the presence of 31 environmental stressors. Residents' perceptions of the severity of the same set of environmental stressors were assessed using a household survey. Qualitative in-depth interviews explored how residents conceptualize everyday exposure to environmental stressors and issues of social and environmental inequity.Results indicated that residents' perception of their environment was a significant predictor of self-reported general health, depression, and sense of community. A decrease in the perception of environmental annoyances, including noise and odors, significantly predicted an increase in general health and an increase in sense of community. An increase in perception of annoyances, perception of blight, and perception of industry all predicted an increase in depressive symptoms. Results of the qualitative component also indicated that environmental stressors, especially those stressors related to blighted neighborhoods, affected residents' physical and mental well-being. A comparison of residents' perceptions and raters' observations of stressors demonstrated agreement in terms of ordering which stressors were most frequently present in the neighborhoods, but indicated that residents perceived environmental stressors to be present more frequently than the checklist raters.Based on the results of this study, it is proposed that future risk assessment practices include residents in environmental assessment processes and policymaking and utilize a combination of methods, including Geographical Information Systems (GIS) and qualitative interviews, to more comprehensively assess and address environmental stressors. It is recommended that environmental intervention and prevention programs address social, political, and economic concerns and target structural as well as individual-level changes for sustained improvements in the environment and health.