Social Participation, Neighborhood Disorder, and Social Cohesion: Predicting Low-Income Mothers' Health and Mental Health

Background/Purpose: It is well-recognized that community-level and neighborhood factors—measures of disorder and social cohesion and poverty—can influence physical and mental health. What is less understood is the extent to which participating in one’s own community matters for health above and beyond these neighborhood process variables affecting health. The purpose of this study is to examine the influence of self-reported social participation, neighborhood disorder, and neighborhood social cohesion on mothers’ health and mental health outcomes. While there is existing research to support an association between neighborhood disorder, social cohesion, and health, there is limited evidence examining the role of social participation in context of these other factors—particularly among low-income mothers. We investigated two research questions: (1) Are religious and social participation and neighborhood factors (neighborhood disorder, social cohesion, and informal social control) predictive of mother’s physical health status?; (2) Are religious and social participation and neighborhood factors (neighborhood disorder, social cohesion, and informal social control) predictive of mother’s mental health outcomes (depression and anxiety)?

Methods: We used year 3 data from the Fragile Families and Child Well-being Study (1998-2013), a birth cohort study of 4,898 US children which oversampled low-income, non-martial births. Our final sample (N=3,130 mothers) with complete data on all variables of interest was used for analysis. Independent variables were religious and social participation, neighborhood disorder, neighborhood social cohesion, and informal social control. The participation variables were dichotomized indicating whether the mother reported going to church or participating in religious groups (religious participation) and whether the mother reported participating in any of a series of community groups (e.g. a service club).  Dependent variables were: general physical health, depression, and anxiety. Self-reported health was measured using an ordinal scale; depression and anxiety were dichotomous variables. We controlled for mothers education level, race, age, income, and marital status. We used step-wise linear regression to predict mothers’ physical health and logistic regression models to estimate the odds of mothers’ meeting criteria for a diagnosis of depression and anxiety. 

Results: Religious participation had no significant association with mothers’ general physical health, but social participation predicted better physical health (p<.05). However, this result became non-significant once control and neighborhood variables were added to the model. Neighborhood disorder and social cohesion were both statistically significant predictors of mothers’ health (p<.05). Religious and social participation did not influence the odds of depression or anxiety. However, higher levels of neighborhood disorder resulted in increased odds for mothers’ diagnosis of both depression and anxiety. Increased neighborhood social cohesion was associated with decreased odds of diagnosis of depression, but not anxiety.

Conclusions and Implications: Overall, findings indicate that social participation influences mothers’ physical health outcomes, but community and neighborhood factors are more impactful. For mothers’ mental health outcomes, neighborhood factors appear even more important. This study provides further evidence that individual factors—such as efforts to participate in religious, social, and community groups—may be insufficient to overcome the detrimental effects of macro-level factors (e.g. poverty and neighborhood insecurity) on mothers’ physical and mental health.