Stress and health behaviors as potential mediators of the relationship between neighborhood quality and allostatic load

Purpose: Neighborhood quality is associated with health. Increasingly, researchers are focusing on the mechanisms underlying that association, including the role of stress, risky health behaviors, and subclinical measures such as allostatic load (AL). Methods: This study uses mixed-effects regression modeling to examine the association between two objective measures and one subjective measure of neighborhood quality and AL in an ethnically diverse population-based sample (N = 2706) from a medium-sized Texas city. We also examine whether several measures of psychological stress and health behaviors mediate any relationship between neighborhood quality and AL. Results: In this sample, all three separate measures of neighborhood quality were associated with individual AL (P < .01). However, only the subjective measure, perceived neighborhood quality, was associated with AL after adjusting for covariates. In mixed-effects multiple regression models there was no evidence of mediation by either stress or health behaviors. Conclusions: In this study, only one measure of neighborhood quality was related to a measure of health, which contrasts with considerable previous research in this area. In this sample, neighborhood quality may affect AL through other mechanisms, or there may be other health-affecting factors is this area that share that overshadow local neighborhood variation. (C) 2018 Elsevier Inc. All rights reserved.