Background: Health and conditions for health are unevenly distributed across neighbourhoods. Within a salutogenic perspective, neighbourhood-resources can be internalised, and become generalised resistance resources. This paper aims to examine whether the neighbourhood could be a supportive arena for health-promotion, and for whom.
Design and methods: A cross-sectional study, based on register data from the population-survey in Malvik, Norway, (N=865) was conducted. Using multiple regression analysis, total sample and sub-group analyses (men/women, low/high earners, employed/unemployed) of 5 independent neighbourhood-measures (overall satisfaction, neighbourhood Social Capital, satisfaction with availability and quality of neighbourhood-resources, and neighbourhood participation) on Sense of Coherence (SOC) and health respectively were obtained.
Results: Overall satisfaction (β=0.153) and neighbourhood social capital (β=0.134) emerged as the most consistent partial correlates of SOC across groups. In turn, SOC was the strongest coefficient for health-outcomes (β=0.238). Neighbourhood participation had more consistent correlations with health than SOC across groups. Group-differences became visible in proportions of explained variance in SOC (varying from 7 to 23.7%) and health (varying from 6.7 to 20.6%), and in the relative importance of neighbourhood-variables. Satisfaction with quality of neighbourhood-resources was significantly related to SOC in non-workers (β=0.451) and low-earners (β=0.261), and health-outcomes in women (β=0.143).
Conclusions: Health might be promoted in the neighbourhood mainly through strengthening SOC, and deprived groups, especially non-workers, may benefit most from health-promotion in the neighbourhood. Findings suggest that high satisfaction with quality can contribute to better health-outcomes for groups with weaker average SOC. The proposed theoretical framework is only partly supported. Significance for public healthThe creation of health-promoting settings has been outlined as one of the main strategies ahead by the Ottawa-charter. Findings from this study suggest that health can be promoted through the neighbourhood, both through strengthening Sense of coherence (SOC), and providing resources for health-promotion. It is suggested that the neighbourhood might be of benefit for promoting health in groups which might be otherwise hard to reach, such as people outside the work-force. Moreover, investigating the relationships between various perceptions of neighbourhood-resources and SOC/health across groups allows for developing strategies for positive change, including improving quality of neighbourhood-resources, and facilitating neighbourhood participation.
Keywords: group differences; health; health promotion; neighbourhood; sense of coherence.