ArticlePloS one2020
Unfavorable perceived neighborhood environment associates with less routine healthcare utilization: Data from the Dallas Heart Study.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- The Brain Vulnerability Index: Development and Validation of a Machine Learning-Derived, Community-Informed Geospatial Risk Score for Cognitive Impairment.Research square · 2026Article
- Firearm Violence and Dental Health: A Neighborhood Analysis in 100 U.S. Cities, 2014-2022.American journal of preventive medicine · 2025Article
- Tobacco policies and changes in the tendency of smoking cessation in cigarette users in Chile: a longitudinal cross-sectional study.BMJ open · 2024Article
- Perceived neighborhood disorder and achieving HIV viral suppression among adults living with HIV: A cross-sectional study.PLOS global public health · 2024Article
- Neighborhood characteristics and HIV treatment outcomes: A scoping review.PLOS global public health · 2024Article
- Reciprocal Neighborhood Dynamics in Gun Violence Exposure, Community Health, and Concentrated Disadvantage in One Hundred US Cities.Journal of urban health : bulletin of the New York Academy of Medicine · 2023Article
- Facilitators and barriers of implementation of routine postnatal care guidelines for women: A systematic scoping review using critical interpretive synthesis.Journal of global health · 2023Article
- Structural racism and violence: Routine healthcare access in a cohort of marginalized Indigenous women and Two-Spirit Peoples during the COVID-19 Pandemic.Research square · 2023Article
- The association between socioeconomic status and use of potentially inappropriate medications in older adults.Journal of the American Geriatrics Society · 2023Article
- Article
- Multi-Modality Imaging for Prevention of Coronary Artery Disease and Myocardial Infarction in the General Population: Ready for Prime Time?Journal of clinical medicine · 2022Review
- Intersectional differences in serious violent victimization trajectories across the life course.Preventive medicine reports · 2022Article
- Geospatial Analysis of Neighborhood Environmental Stress in Relation to Biological Markers of Cardiovascular Health and Health Behaviors in Women: Protocol for a Pilot Study.JMIR research protocols · 2021Article
- Social determinants of health, health disparities, and adiposity.Progress in cardiovascular diseasesReview
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9 authors.
Funding
Abstract
Neighborhood environment perception (NEP) has been associated with health outcomes. However, little is known about how NEP relates to routine healthcare utilization. This study investigated the relationship between NEP and independent subfactors with healthcare utilization behavior, as measured by self-reported (1) usual source of healthcare and (2) time since last routine healthcare check-up. We used cross-sectional data from the Dallas Heart Study, which features a diverse, probability-based sample of Dallas County residents ages 18 to 65. We used logistic regression modeling to examine the association of self-reported NEP and routine healthcare utilization. NEP was assessed via a questionnaire exploring residents' neighborhood perceptions, including violence, the physical environment, and social cohesion. Routine healthcare utilization was assessed via self-reported responses regarding usual source of care and time since last routine healthcare check-up. The analytic sample (N = 1706) was 58% black, 27% white, 15% Hispanic, 42% male, and had a mean age of 51 (SD = 10.3). Analysis of NEP by tertile demonstrated that younger age, lower income, and lower education were associated with unfavorable overall NEP (p trend <0.05 for each). After adjustment for potential confounders, including neighborhood deprivation, health insurance, disease burden and psychosocial factors, we found that individuals with more unfavorable perception of their physical environment were more likely to report lack of a usual source of care (p = 0.013). Individuals with more unfavorable perception of the neighborhood physical environment or greater neighborhood violence reported longer time periods since last routine visit (p = 0.001, p = 0.034 respectively). There was no relationship between perceived social cohesion and healthcare utilization. Using a multi-ethnic cohort, we found that NEP significantly associates with report of a usual source of care and time since last routine check-up. Our findings suggest that public health professionals should prioritize improving NEP since it may act as barrier to routine preventive healthcare and ideal health outcomes.
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