Neighborhoods matter: how neighborhoods impact adolescent health

girls photo via National Park Service
Researchers and public health advocates recognize the importance of understanding social determinants of health, the complex array of conditions that have been shown to have significant impact on health outcomes. However, most efforts aimed at improving adolescent health still focus on individual behaviors rather than acknowledging the role of communities in shaping adolescents’ health. New research from the Institute for Health Policy Studies aims to provide a clearer understanding of these dynamics and help guide future programming and policy.

Their review examines the relationship between neighborhood characteristics and adolescent pregnancy, contraceptive use, when adolescents start having sex, and birthrate. The studies they looked at found consistent associations between poverty, education, and employment with adolescent sexual health outcomes. Increased neighborhood poverty was linked with increased risk of adolescent pregnancy and higher birthrates, and decreased likelihood of contraceptive use. On the other hand, higher levels of education and adult employment at the neighborhood level showed opposite results. This strongly supports the current understanding that economic and institutional scarcity within neighborhoods is associated with increasingly risky sexual and reproductive health behaviors and outcomes among adolescents.

Studies found that factors like increased social support and neighborhood cohesion were linked to decreased risk of becoming sexually active, increased contraceptive use and decreased adolescent birthrates. The studies did not find a consistent relationship between neighborhood racial or ethnic composition and sexual initiation or use of contraceptives.

There are areas that deserve more attention. Over the last decade, more research has focused on disadvantages over the impact of positive neighborhood factors. Also, most studies divided neighborhoods by census tracts or zip codes, rather than looking at the the full landscape of what constitutes a neighborhood in young people’s lives. The researchers call for more nuanced profiles of neighborhoods to help tailor policies and programs to better respond to needs of different communities.