Formal and Informal Neighborhood Social Organization: Which Supports Resident Health?

BACKGROUND & PURPOSE. Neighborhood social organization is an often proposed, but less frequently examined mechanism through which neighborhoods affect health of residents. Evidence suggests that lower informal neighborhood social organization (including social trust and social cohesion) is associated with poorer health (Diez Roux & Mair, 2010). Informal social organization captures psychosocial aspects of organization—what residents think and feel about their environment. Formal social organization, on the other hand, captures the engagement of residents and others with the neighborhood. It is the presence of established organizations and engagement with those organizations. Nevertheless, researchers have not examined formal neighborhood organization and health. Formal social organization may be especially important for understanding how social policy can improve neighborhoods because it may help capture structural disadvantage and disinvestment in communities. This study examines whether informal and formal neighborhood social organization predict resident self-rated health, if one type of social organization is a stronger predictor, and finally, if neighborhood social organization is robust to individual participation.

METHODS. This study used data from the Chicago Community Adult Health Study (CCAHS) survey and organizational data from InfoUSA. Respondents were 3105 adults (age 18-92) from 343 neighborhood clusters in Chicago. The sample is diverse: 31.7% are White, 25.8% are Hispanic/Latino, and 40.0% are Black. Self-rated health is a one-item measure of perceived health with five response options ranging from poor to excellent. Informal social organization was measured by respondent perceptions of neighborhood social cohesion and instrumental control aggregated to the neighborhood level. Formal social organization was measured with a composite measure of aggregate respondent report of participation in civic activities, contact with officials, as well as the density of child and other social service organizations in the neighborhood. Multilevel ordered logistic regression models with fixed effects were estimated in Stata 13. Individual controls included demographic characteristics, language of interview, and depressive symptoms.

FINDINGS. Both formal and informal social organization are associated with better self-rated health in models with no individual controls. Only formal social organization remains significant (OR=1.14, p<.05, CI [1.03, 1.26]) in the final model. With the inclusion of individual-level measures of participation, formal social organization remains significant (OR=1.12, p<.05, CI [1.01, 1.24]).

IMPLICATIONS. Results suggest that formal neighborhood social organization is important for resident health. Social organization is a modifiable community strength.Place-based policies may improve health in target neighborhoods by strengthening the organizational infrastructure. Implications of the measurement strategy will be discussed as they relate to future research and evaluation of neighborhood social organization.