Fear of neighborhood violence link to adolescent obesity

A PHS 795 student writes:

Displaying an interesting relationship to findings from the Moving to Opportunity Housing Mobility Experiment described in Dr. Stephanie Robert’s lecture, a study in the department of psychiatry at the University of Michigan found that fear of violence in neighborhoods at age 15 was predictive of increased BMI a decade later for females, but not for males. Just as males were less likely to be positively influenced by a change in neighborhood in the Moving to Opportunity Housing Mobility Experiment, males were less likely to be negatively influenced by negative aspects of their neighborhoods in this study. It would be interesting to study what the contributing factors may be to male resilience to the positive or negative effects of their surroundings. Another interesting detail of the experiment was that victims or observers of violence did not display the same prediction of BMI as those who simply feared violence. A follow-up study as to how chronic vs acute fear plays into body weight may be useful to understanding the effects of neighborhoods on physical and mental wellbeing. This study reinforces the idea that your neighborhood can be a key factor in predicting your health outcomes, even years after you have moved away.

http://archtrauma.com/?page=article&article_id=31475

Interesting observation about fear possibly playing a role (mediator? moderator?). It reminds me of work by PHS graduate Dr. Abiola Keller that suggested stress was associated with morbidity and mortality but only for those who believed that stress was harmful to health (we will see a related video in Dr. Paul Creswell’s upcoming lecture). It also reminds me of this:

“I must not fear.Fear is the mind-killer.Fear is the little-death that brings total obliteration.I will face my fear.I will permit it to pass over me and through me.And when it has gone past I will turn the inner eye to see its path.Where the fear has gone there will be nothing. Only I will remain.” (Frank Herbert. Litany Against Fear. Dune)

(but then again, I am a total nerd)

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3 thoughts on “Fear of neighborhood violence link to adolescent obesity

  1. This type of research is very interesting for those of us who focus on the built environment. There is an unresolved dilemma in the research community about which measures of the built environment are most appropriate: objective (GIS data, reliable neighborhood audits, etc.) or subjective (surveys of how people feel about their neighborhood).

    On the one hand, data on objective measures can be more helpful in framing interventions. While not trivial, it is easier to change a facet of the built environment (add sidewalks or pocket parks, for instance) than it is to understand why people feel a certain way about an environment and then either change the way they feel or change the facet of the built environment that makes them feel that way. This is, of course, complicated by the fact that not everyone feels the same way about the same environment or even responds to their own feelings with the same behaviors (as evidenced by the difference in results in the above-mentioned study between males and females).

    On the other hand, survey data is often (if not always) easier to come by than objective data about the built environment. And, if the association between built environment and health behaviors is moderated by perceptions of the built environment, then simply building differently may not change people’s behavior.

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  2. As I read through the Assari, et.al. paper, I was reminded of Robert Sapolsky’s paper, “Sick of Poverty” in which he describes the effects of chronic stress on our health. Psychosocial stress as described by Sapolsky is very commonly a prolonged or chronic exposure to stressors which mimics the effects of physical stressors; psychosocial and physical stressors are biologically one in the same. Whereas it is evolutionarily advantageous for us to respond to acute physical stressors, however, it is not adaptive to respond similarly when exposed to the chronic psychosocial stressors modern humans commonly experience today. Sapolsky talks about the effects of low socioeconomic status, being made to feel poor, and a lack of social capital contributing to psychosocial stress and diminished health, but I think it is a fairly safe extrapolation to include fear of violence in this discussion.
    This observation is of course flawed (or more likely incomplete) when one considers the premise of this paper: that the fear of violence predicts development of obesity in African American women but not men. It was acknowledged in the paper that African American “boys are more likely to experience assaults while girls are more likely to be exposed to sexual violence.” In this sense, women are certainly not alone in experiencing the fear of violence, but the manifestation of this fear in poor health outcomes is only seen in the women in this context. This suggests to me that obesity in women is only one part of the much larger unacceptable story about how stressful environments are contributing to poorer health outcomes in disadvantaged neighborhoods.

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  3. Our social networks, friends, and environments shape our perceptions, and this study shows us how our perceptions can have a great impact on our health outcomes. Flint, Michigan is a place that has been devastated by deindustrialization, white flight, poverty, and now a water crisis. These structural and environmental problems can create a barrier for an individual to attain employment, go to school, and eat healthy, but it can also change their core beliefs. This study looks at how the fear of violence alone can be a predictor of obesity in African-American women, which provides even more support for developing policies that promote neighborhood safety.
    On another note, I am interested in the fact that there were such major differences in the results based on gender. In the research by Gustafsson et al. on allostatic load, they found that neighborhood disadvantages had a greater impact on men. Previous studies found that women were more likely to have a greater allostatic load due to neighborhood stressors because of their role in the community. Women tended to be more embedded in the community, which could be seen as protective of stress or a cause of stress. I hope to learn more about how gender differences need to be considered when looking at public health interventions.

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