Stigmatized Neighborhoods, Social Bonding, and Health

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Abstract

The relationship between living in impoverished neighborhoods and poor health is well established, but impacts of neighborhood stigma on health are not well understood. Drawing on long-term research with Latino immigrants, we examine how neighborhood stigma and social bonding affect health in Phoenix, Arizona. During preliminary ethnographic analysis, we developed a novel neighborhood stigma scale. In survey research, we examined effects of neighborhood stigma and social bonding on self-reported physical and mental health. Regression models show that perceived neighborhood stigma and low social bonding are associated with poorer physical and mental health, controlling for other factors.

South Phoenix Market, August‎ ‎28‎, ‎2009, by Ms. Phoenix.

South Phoenix Market, August‎ ‎28‎, ‎2009, by Ms. Phoenix.

Author biographies
Amber Wutich is an Associate Professor of Anthropology at Arizona State University, and Dr. Wutich is affiliated with the Global Institute for Sustainability, Center for Global Health, and Center for the Study of Institutional Diversity at ASU. Her research examines how inequity and injustice in social systems produce food and water insecurity; and how people cope with resource insecurity and what happens when they can no longer cope.

Alissa Ruth is the Director of Student and Academic Services for the School of Human Evolution and Social Change at Arizona State University. Her research explores immigration to the U.S. and undocumented immigrant youth with a focus on how undocumented immigrant youth, called DREAMers, utilized their knowledge of U.S. cultural and society to form communities and claim rights.

Alexandra Brewis serves as Director of Arizona State University’s School of Human Evolution and Social Change. She also serves simultaneously in ASU’s Office of Knowledge Enterprise as an Associate Vice President, helping to advance social science research institution-wide. Her research is concerned with how culture shapes human biology in the contexts of such massive, uncertain, and dynamic processes as climate change, growing social inequalities, urbanization, and globalization. Topically, she is focused on two fundamental, complex, and expanding problems related to the intersection of sustainability and health: obesity and water insecurity.

Christopher Boone is a Professor of Sustainability and Human Evolution and Social Change at Arizona State University. He studies the nature of cities, urban life, and the relationship between cities and the natural environment, primarily from a historical point of view. He is particularly interested in the processes responsible for changes in the urban landscape and the consequences of those changes for human beings and the environment.

Additional publications by the authors
Wutich, A., Brewis, A., Sigurdsson, S., Stotts R., & York, A. (2013). Fairness and the human right to water: A preliminary cross-cultural theory. Pp. 220-238. In J. Wagner, ed., The Social Life of Water in a Time of Crisis. New York: Berghahn Books.
Wutich, A., White, A. C., White, D. D., Larson, K. L., Brewis, A., & Roberts, C. (2014). Hard paths, soft paths, or no paths? Cross-cultural perceptions of water solutions. Hydrology and Earth System Sciences, 18(1), 109–120. doi:10.5194/hess-18-109-2014.
Vins, H., Wutich, A., Brewis, A., Beresford, M., Ruth, A., & Roberts, C. (2014). Gender and Children’s Perceived Water Futures in the U.S. Desert Southwest. Human Organization, 73(3).

Editorial Footnotes
If you enjoyed this article, you might be interested in previously published Medical Anthropology Quarterly articles on stigma including Marcia Ellison’s (2003) “Authoritative Knowledge and Single Women’s Unintentional Pregnancies, Abortions, Adoption, and Single Motherhood: Social Stigma and Structural Violence,” Janis Jenkins and Elizabeth Carpenter-Song’s (2008) “Stigma Despite Recovery Strategies for Living in the Aftermath of Psychosis,” or Juliene Lipon’s “Multiple Chemical Sensitivities: Stigma and Social Experiences.”

In addition, consider the previously published Medical Anthropology Quarterly articles on the experiences of immigrants including Sarah Horton and Judith Barker’s (2009) “Stigmatized Biologies: Examining the Cumulative Effects of Oral Health Disparities for Mexican American Farmworker Children,” Sarah Horton’s (2004) “Different Subjects: The Health Care System’s Participation in the Differential Construction of the Cultural Citizenship of Cuban Refugees and Mexican Immigrants,” and Lucia Volk’s (2009) “‘Kull wahad la haalu’: Feelings of Isolation and Distress among Yemeni Immigrant Women in San Francisco’s Tenderloin.”

Interview with the authors
1. How much of an impact does time spent in a place have on the relationships between neighborhood stigma, social bonds, and health?

While more research is needed to uncover the complexities of neighborhood stigma, social bonds and health, we can hypothesize that the longer someone lives—and actually spends time within a neighborhood—the more likely they may be to create more, stronger, or more meaningful social bonds. However, the nature of the connectedness to the neighborhood itself and among the people in that community is key. The length of time in a neighborhood would not necessarily translate into greater social bonding if there is no interaction among community members. Another important consideration is a person’s attachment to their community or place, which may not be entirely dependent on how long they live there. With technology connecting people instantaneously, physical presence may not be needed to create and maintain those bonds. Thus, it is the quality of the social bonds, rather than the actual length of time in a neighborhood, we believe will ultimately be more important for understanding health outcomes.

2. In many cities, neighborhoods are racially/ethnically divided, with people opting to live in communities with people who are culturally similar. How might this influence the social bonds, stigma, and health relationship?

We know that it is typically easier for people who have similar backgrounds (e.g. age, education level, ethnic/cultural background, etc.) to create relationships than people who have disparate upbringings. Moreover, we can assume that a community that has a strong, cohesive sense of identity and belonging may foster greater social bonds, which in many cases can create a protective mechanism against stigma. While neighborhoods may be ethnically homogenous, that does not automatically mean that there will be a greater sense of shared community and identity. People may choose to live in neighborhoods that appeal to their cultural background, but these neighborhoods may fail to provide opportunities for people to meet and get to know each other. Also, we are finding that in low-income neighborhoods, the burden of economic obligations to neighbors and the burden of neighborhood disamenities (e.g., poorly maintained infrastructure) can undermine or mitigate the health benefits of social bonds. Therefore, a variety of factors, including but not limited to cultural similarities, contribute to the likelihood that strong social bonds will be present and that they will assist in improving health.

Questions for classroom discussion
1. This study reveals that race/ethnicity does not impact health independently, yet we know that in the U.S. minority groups have poorer health outcomes. How does this study help us understand this situation?
2. This study points to the positive impact of social bonds on health outcomes. There is also literature cited in this article that suggests strong social bonds may negatively impact health. How can public health campaigns harness the positive components of social bonding while not overburdening individuals to maintain their own health with no change to structural inequities?

Race and ethnicity 2010: Phoenix by Eric Fischer, Red is White, Blue is Black, Green is Asian, Orange is Hispanic, Yellow is Other, and each dot is 25 residents, updated for Census 2010.

Race and ethnicity 2010: Phoenix by Eric Fischer, Red is White, Blue is Black, Green is Asian, Orange is Hispanic, Yellow is Other, and each dot is 25 residents, updated for Census 2010.

Additional readings
Airey, L. (2003). “Nae as Nice a Scheme as It Used to Be”: Lay Accounts of Neighbourhood Incivilities and Well-being. Health & Place, 9, 129-137.
Davidson, R., Mitchell, R., & Hunt, K. (2008). Location, Location, Location: The Role of Disadvantage in Lay Perceptions of Area Inequalities in Health. Health & Place, 14, 167-181.
Kawachi, I., Subramania, S. V., & Kim, D. (2008). Social Capital and Health. New York: Springer.
Kelaher, M., Ward, D., Feldman, P., & Tacticos, A. (2010). Living in Birdsville: Exploring the Impact of Neighborhood Stigma on Health. Health and Place, 16, 381-388.
Lomnitz, L. (1977). Networks and Marginality: Life in a Mexican Shantytown. New York: Academic Press.
Stack, C. B. (1974). All Our Kin: Strategies for Survival in the Black Community. New York: Harper and Row.

Other resources
Social Dynamics in Response to Shifting Immigration Policy and Practice: Latino Social Networks, Resource Flow, and Household Reorganization.
Arizona State University, Julie Ann Wrigley Global Institute of Sustainability