The global burden of disease.

Features of neighborhoods or residential environments may affect health and contribute to social and race/ethnic inequalities in health. The study of neighborhood health effects has grown exponentially over the past 15 years. This chapter summarizes key work in this area with a particular focus on chronic disease outcomes (specifically obesity and related risk factors) and mental health (specifically depression and depressive symptoms). Empirical work is classified into two main eras: studies that use census proxies and studies that directly measure neighborhood attributes using a variety of approaches. Key conceptual and methodological challenges in studying neighborhood health effects are reviewed. Existing gaps in knowledge and promising new directions in the field are highlighted.

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Neighborhoods and health.

The inverse relationships between socioeconomic status (SES) and unhealthy behaviors such as tobacco use, physical inactivity, and poor nutrition have been well demonstrated empirically but encompass diverse underlying causal mechanisms. These mechanisms have special theoretical importance because disparities in health behaviors, unlike disparities in many other components of health, involve something more than the ability to use income to purchase good health. Based on a review of broad literatures in sociology, economics, and public health, we classify explanations of higher smoking, lower exercise, poorer diet, and excess weight among low-SES persons into nine broad groups that specify related but conceptually distinct mechanisms. The lack of clear support for any one explanation suggests that the literature on SES disparities in health and health behaviors can do more to design studies that better test for the importance of the varied mechanisms.

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Socioeconomic Disparities in Health Behaviors

ference of 4.61 percentage points (95% confidence interval (CI), −8.54 to −0.69), 3.38 percentage points (95% CI, −6.39 to −0.36), and 4.31 percentage points (95% CI, −7.82 to −0.80), respectively. The differences between the group receiving traditional vouchers and the control group were not significant. CONCLUSIONS The opportunity to move from a neighborhood with a high level of poverty to one with a lower level of poverty was associated with modest but potentially important reductions in the prevalence of extreme obesity and diabetes. The mechanisms under - lying these associations remain unclear but warrant further investigation, given their potential to guide the design of community-level interventions intended to improve health. (Funded by HUD and others.)

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Neighborhoods, Obesity, and Diabetes — A Randomized Social Experiment

Collective efficacy in Denver, Colorado: Strengthening neighborhoods and health through community gardens.

Collective efficacy and obesity: The potential influence of social factors on health

Collective Efficacy and Obesity

: This report explores ways in which the Army might improve its ability to contribute to the prompt, global power-projection capability of the United States. By that the authors mean the strategic responsiveness of early-entry forces in situations where time is critical. Through a case study based upon the Army's new Stryker Brigade Combat Team (SBCT), the authors examine two components of early-entry force strategic responsiveness: rapidly tailoring a mission-focused force package and moving the force. The report begins by analyzing options, given existing technology, for improving the deployment time of Army units. Then it examines how the Army might improve its ability to facilitate the rapid-deployment initiation of joint, mission-tailored packages of capabilities. In essence, there are two problems: initiating deployment of the right force capabilities and then getting these capabilities where they need to be as quickly as possible. Specific issues examined in the report include forward basing, new concepts in prepositioning, significant but underappreciated opportunities in process improvement, and speeding the delivery of initial operating capabilities through deployment phasing and improved planning. The research offers an approach for leveraging force modularity concepts to transition to a capabilities-based, rapid mission, force-tailoring construct. (3 tables, 38 figures, 32 refs.)

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Speed and Power: Toward an Expeditionary Army

An ability to deploy capable combat forces quickly is increasingly seen as an important national capability. Such forces could be needed for small contingencies or as the initial element for a large conflict.

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Aimee Bower

Papers

Collective efficacy and obesity: The potential influence of social factors on health

Collective Efficacy and Obesity

Speed and Power: Toward an Expeditionary Army

Toward an Expeditionary Army