An important methodological problem is the study of causal pathways to health and well-being. The association between low socioeconomic status and poor health is well established (Adler & Stewart, 2010). A useful model, the SES gradient in health details the link between health disadvantages for people in lower socio-economic groups. This graded relationship with health includes individual level indicators (income, occupation, educational level) and neighbourhood-level characteristics (Marmot, 2005; Pickett & Pearl, 2001; Van Lenthe, Schrijvers, Droomers, Joung, Louwman, & MacKenbach, 2004). Research suggests there are a number of
problems with different causal pathways for the social gradient in health. Researchers suggest there are two important pathways the first includes health risk behaviours
53 (e.g. smoking, diet) and secondly differences in psychosocial weaknesses (e.g.
stress, social support) (Mulatu & Schooler, 2002). There is a lack of consensus about the relative importance of the two pathways and they may be related to different measures of SES (Jaarsveld , Miles, & Wardle, 2007). A UK study with a large sample of mature adults (age 55-64 years) by Jaarsveld et al., (2007) investigated individual deprivation (measured by education level, housing tenure and car ownership) and neighbourhood deprivation defined by 29 deprivation indicators from the 1991 census. The authors found evidence that the psychosocial pathway was relatively less critical when a neighbourhood measure of deprivation was used, but both pathways were equally important for the individual level measure. The authors suggested individual deprivation might affect health through its association both with unhealthy behaviours and more unfavourable psychosocial characteristics. Although more deprivation does not make a person smoke, eat less fruit and vegetables, or take less exercise,
individuals are affected by social circumstances in a way which makes it harder for them to invest in their own health and increases their psychosocial vulnerability (Oakes & Rossi, 2003). It is important to interpret carefully the influence of
neighbourhood measures as studies have shown they tap into different underlying phenomena and seem to connect different paths of influence (Ostrove, Feldman, & Adler, 1999; Bradley, Bradley, Cupples & Irvine, 2002; Chen, 2006).
A further challenge is the differences in measures of individual deprivation and neighbourhood deprivation. The UK study (Jaarsveld et al., 2007) noted differences between participants’ individual measures and the neighbourhood measure. For example 14% of people in the less deprived individual categories lived in a neighbourhood classified as more deprived and 19% of people from the more deprived individual categories lived in less-deprived neighbourhoods. Studies
comparing adolescent individual and neighbourhood deprivation would be valuable as most studies explore adult populations. There may be differences for young people
54 compared to older members of a neighbourhood in the differences between individual and neighbourhood deprivation measures. Older adults may be less mobile and may stay in a neighbourhood which may change in deprivation level over time. Examining adolescents’ responses about their individual deprivation and neighbourhood
deprivation may help understanding about the variation in neighbourhood measures. This may be relevant when studying relative deprivation as census data may suggest an adolescent resides in an area of deprivation but the individual neighbourhood measure may be different. In research, where possible, it is essential to include different ways of defining neighbourhood deprivation to improve the robustness of the study design.
Another complexity when researching the influence of neighbourhood contexts is the need to distinguish between the properties of moderator and mediator variables. Often these definitions are confused in research (Baron & Kenny, 1986). Moderator
variables such as parenting behaviour are important as contextual factors which may reduce or enhance the influence of the neighbourhood on a young person’s health behaviours e.g. parental models have shown a moderating effect for four health enhancing behaviours including eating a healthy diet (Turbin, Jessor, Costa, Dong, Zhang & Wang, 2006). Emotional support from parents has consistently been found to protect adolescents from neighbourhood factors which are detrimental to health and well-being (Lachausse, 2008). In contrast peer support has not been found to be a risk factor for adolescents (Leventhal & Brooks-Gunn, 2000). Research by Windle (1992) into social support and teenagers confirmed family support was a potential moderator variable which was inversely related to depression and delinquency. Contrastingly the authors concluded perceived peer support was not a moderator variable but friend support was positively related to delinquency. This result
represents peer support as a suppression effect, having non-significant zero-order correlations with outcomes but showing significant effects in multivariate analyses
55 (Piko, 2000). Such findings suggest the influence of peer support are complex and may involve several pathways.
Neighbourhood effects on adolescents are more likely to be mediated by peer association (Leventhal & Brooks-Gunn, 2000). This is illustrated in a study by Urban (2010) in Hungary. The author found perceived peer smoking was an important mediator between sensation seeking and smoking. The author discussed smoking was mediated by the peer mechanisms of peer pressure and peer selection.
Longitudinal research by Wills (Wills, Sandy, Shinar, Yaeger, 1999) into adolescent substance abuse found adolescent boys who entered peer groups with low parental support, high stress and low academic competence were more vulnerable to rapid escalation in substance abuse than other members of a peer group. The effect of individual differences such as age, gender and ethnic identity, need to be taken into account when clarifying the relationship between risk or protective factors and outcomes variables. Therefore when studying neighbourhood effects it is crucial to clarify where feasible, the pathways through which peers affects young people’s health and well-being. The ecological approach to studying neighbourhoods has the implicit idea that neighbourhood influences can be indirect e.g. families influence the effect of neighbourhood resources such as school, which then influences the child; the neighbourhood level of danger may influence parenting within the home.
A further issue is the limited methods used by researchers (Odgers et al., 2009). The majority of neighbourhood research focuses on census level data or parental reports of neighbourhood context. The exclusive use of census tract data narrows the information about the neighbourhood demography and limits the possibility of examining the adolescents’ environment from an ecological perspective. The
importance of social processes is then missed in this type of design. A further problem is the influence of the research design and its effect on results. Many studies into neighbourhood effects on youth use national census tracts and other sources where
56 sampling was not designed with neighbourhood influences in mind (Veenstra et al., 2005). A further problem is the relationship between large sample sizes and the possibility of discerning a small effect which is not meaningful (Cohen, 1992; Sedlmeier & Gigerenzer, 1997). Neighbourhood research suggests the influence of environment effects is small to moderate and large sample studies which find
trivialising small effects need to be carefully interpreted. It is important for researchers designing neighbourhood studies to consider power analysis to improve the validity of their research.
A critical issue for researchers is the issue of parent and child self-report. The reliance on parent reports is difficult as they typically report on the child outcome (e.g. child’s well-being) as well as the predictor (neighbourhood factors). Brener (Brener, Billy & Grady, 2003) discussed the importance in health behaviour studies to carefully assess risks in adolescent self-report. It is essential to consider the factors affecting validity including the issue of social desirability. When using self-report methods with
adolescents the possibility of response bias exists, due to the desire for attention, or perhaps the desire to seem ‘cool’ or ‘bad’. In a meta review of 100 studies, Brener et al., (2003) examined self-report for six types of health risk behaviours (alcohol and other drug use; tobacco use; behaviours related to unintentional injuries and violence; dietary behaviours; physical activity and sexual behaviour) and found that they were affected by cognitive and situational factors. These factors do not threaten the validity of self-reports of each type of behaviour equally. Researchers should consider the threats to validity and construct their design to reduce these risks. Pre-testing a survey to assess face validity is one way to mitigate against this problem.
Further measurement problems exist when researching social capital and
adolescents. Some of the well-established indicators e.g. trust in neighbours do not have much relevance for young people. Research by Morrow (2002) found young
57 people located trust and reciprocity in individual close relationships rather than in neighbourhoods. Other studies found 48% of young people aged 11 to 18 would not trust the ordinary man or woman in the street compared to 30% of adults (Mori, 2003). Other differences were found in the General Household Survey (ONS) questions about social capital. The survey in 2000 found differences in the indicators for social capital e.g. 13% of the 16-25 year group responded positively to the neighbourliness score compared to 35% for the 25 year plus group. This affirms the importance of integrating research methods to help deliver a fuller picture of how neighbourhoods impact on adolescents.