Are poor people healthier in rich or poor areas? : the psychosocial effects of socioeconomic incongruity in the neighbourhood

摘要

This thesis contributes to the understanding of how health is affected by the interaction between neighbourhood and individual socioeconomic status. It has been found that residents in high status neighbourhoods are healthier than those in low status neighbourhoods, controlling for individual status. Here it is hypothesised that such an association may not be found amongst low status individuals, because such individuals may have more detrimental psychosocial exposures in high status neighbourhoods than in low status neighbourhoods. For low status individuals, these detrimental psychosocial exposures, such as lacking social support and frequent status comparisons, may counteract positive material exposures in high status neighbourhoods. To test this hypothesis, three studies were conducted in this thesis. The first is an analysis of the difference in the association between neighbourhood status and health across individuals of different socioeconomic status, using a sample of mothers from England in the Millennium Cohort Study. The second study is similar and uses the same dataset, but instead of health, psychosocial factors were analysed. The third study, specific to London, uses data from the 2001 census to investigate the health impact of living in a low status city block within a wider neighbourhood of high status. In the first two studies, it was found that the positive association between neighbourhood status and health is weakest amongst the lowest status mothers, and whilst high status mothers were most likely to lack local friends and be depressed in low status neighbourhoods, there was an indication that in certain contexts the lowest status mothers were most likely to lack local friends and be depressed in high status neighbourhoods. In the third study, it was found that low status city blocks within high status neighbourhoods were more likely to have poor average health than those within low status neighbourhoods.