Connecting Neighborhood Characteristics and Clinical Health Outcomes: Novel Data from the Oregon Health Insurance Experiment

Abstract

Although policy often emphasizes health care expansions to improve population health, neighborhood characteristics may also influence outcomes. Documenting the association between neighborhood features and health poses several empirical challenges, including the potential for bias from relying on self-reported outcomes, selection bias from using health care data, and contextual limitations due to a methodological focus on one element of neighborhood attributes. In this exploratory analysis, we introduce rich data linking individual clinical health outcomes from a low-income community sample with primary data on a variety of neighborhood characteristics, and investigate the relationships between multiple aspects of neighborhoods and health. We find that neighborhoods have widely varying combinations of attributes and that residents of areas with lower socioeconomic deprivation, greater grocery store availability, and more active living characteristics were in better health than individuals living outside of these areas. Although this analysis does not establish causal pathways, it provides a foundation for future analyses to examine how neighborhoods interact with health policy and health care access to improve population health.

Keywords: Social determinants of health, population health, neighborhood characteristics, physical and mental health outcomes