PUB - Publikationen an der Universität Bielefeld

Changes of small-area characteristics may be associated with health. Various theories have been proposed to explain small-area effects on health, including those concerning social capital. The effect of small-area demographic changes on health are very little researched and hardly anything is known about their relationship with neighbourhood social cohesion (SC).

We use longitudinal data from the German Socio-Economic Panel linked to demographic measures at the county level to explore the association between 5-year changes in the proportion of 18-24 years-old (young adults) and over 65 years-old (older adults) with mental and physical health along with the interaction effects with perceived neighbourhood SC using random intercept models. Control variables include education, income, and relevant baseline measures.

Included are all participants with a 6-year exposure to their county of residence. The main outcomes are the mental and physical health components (MCS, PCS) of the SF-12 general health questionnaire. The analysis includes 21,239 persons up to 6 times in 399 counties. Five-year changes in the young and older adults as well SC are associated to both MCS and PCS. Significant interactions between the change in older adults and SC are seen for MCS only in rural areas and some interactions are significant for PCS. For MCS there are no interactions between SC and the changes in young adults. Important interaction effects for PCS: for those exposed to a small decrease in young adults, an increase in one unit of SC is associated with an increase of 1.72 (95% CI[1.39, 2.04]) PCS units. For those exposed to a large decrease this effect is lower by 0.87(95% CI [0.44, 1.31]) PCS units.

Exposition to some demographic changes modifies the relationship between perceived SC and health. Thus, indirectly, demographic changes appear to be potential health stressors. The evidence shown by this work needs to be further developed by considering smaller spatial scales but opens up a new range of possible intervention targets to reduce health inequalities.