Contextual effects on health inequalities: a research agenda

The neighbourhood context in which we live can affect our health in many ways. Some are obvious: pollution incurred by living close to a motorway can impact on our respiratory health; or the lack of local possibilities for walking affects how much we exercise, potentially leading to weight gain or cardiovascular problems. Some contextual effects are less direct; mean neighbourhood income can influence the availability of goods, services and facilities in an area and, since these are available to everyone, affect the health of high- and low-income residents.¹ This is an example of the importance of distinguishing individual and contextual effects. Another example of a contextual effect would be neighbourhoods prone to crime and anti-social behaviour being a source of stress and thus increasing, among other things, the risk of mental illness among all of the residents. But then social capital at the neighbourhood level can be a modifying factor, providing resources which then affect social behaviours, leading to healthier lifestyles for all.

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