Association between perceived neighborhood environment and health of middle-aged women living in rapidly changing urban Mongolia

Background: This study was conducted in rapidly urbanizing Ulaanbaatar, Mongolia, to examine patterns of perceived neighborhood quality by residents and the associations between these patterns and self-reported general and mental health in middle-aged women. Methods: A questionnaire survey was administered to 960 women aged 40-60 years. Demographic and socio-economic characteristics, subjects' perception of their neighborhood environment, general health status, and mental health as measured using a 12-item General Health Questionnaire (GHQ12) were reported. Results: A total of 830 women completed the questionnaire. Subjects reporting their general health as very good or good accounted for 80.3% and those with a GHQ12 >= 16, which reflects psychological distress or severe distress, accounted for 16.1%. A principal component analysis of the perceptions of neighborhood environment by the residents identified six qualities: physical environment, designed environment, neighborhood community, public safety, natural environment, and citizen services. The perception of better-quality citizen services in the neighborhood was associated with better self-reported general health (odds ratio [OR] = 1.330, 95% confidence interval [CI] 1.093-1.618), and the perception of better-quality public safety was associated with less psychological distress (OR = 0.718, 95% CI 0.589-0.876); these associations were independent of education, income, occupation, type of residential area, and number of years living in the current khoroo. Conclusions: The perception of the quality of a neighborhood environment can affect the self-reported general and mental health of residents, even after accounting for the type of residential area and individual socio-economic status. Developing high-quality neighborhoods is an essential component of good planning to promote population health in urban environments.