Stressed out? An investigation of whether allostatic load mediates associations between neighbourhood deprivation and health

Deprived neighbourhoods have long been associated with poorer health outcomes. However, many quantitative studies have not evidenced the mechanisms through which place ‘gets under the skin’ to influence health. The increasing prevalence of biosocial data provides new opportunities to explore these mechanisms and incorporate them into models of contextual effects. The stress pathway is a key biosocial mechanism; however, few studies have explicitly tested it in neighbourhood associations. This paper addresses this gap by investigating whether allostatic load, a biological response to chronic stress, mediates relationships of neighbourhood deprivation to physical and mental health. Data from UK Understanding Society is used to undertaken a multilevel mediation analysis. Allostatic load is found to mediate the association between neighbourhood deprivation and health, substantiating the biological mechanism of the stress pathway. More deprived areas are associated with higher allostatic load, and in turn worse allostatic load relates to poorer physical and mental health. Allostatic load is a stronger mediator of physical health than mental health, suggesting the stress pathway is more pertinent to explaining physical health gradients. Heterogeneity in the results between physical and mental health suggests more research is needed to disentangle the biosocial processes that could be important to health and place relationships.OLD Urban Renewal and Housin

Modelling residential segregation as unevenness and clustering: A multilevel modelling approach incorporating spatial dependence and tackling the MAUP

Traditional studies of residential segregation use a descriptive index approach with predefined spatial units to report the degree of neighbourhood differentiation. We develop a model-based approach which explicitly includes spatial effects at multiple scales, recognising the complexity of the urban environment while simultaneously distinguishing segregation at each scale net of all other scales. Moreover, this model distinguishes segregation as unevenness and as spatial clustering in the presence of stochastic variation. The modelling approach, unlike traditional index approaches, allows hypothesis evaluation concerning alternative scales and zonation through an accompanying badness-of-fit measure. Ultimately, this permits the identification of the scale and zonation regime where the spatial patterns come into focus thereby directly tackling the modifiable areal unit problem. The model is applied to Indian ethnicity in Leicester, UK, finding segregation as unevenness and as spatial clustering at multiple scales.OLD Urban Renewal and Housin