When it comes to preventing a stroke, living in a neighborhood where you have strong social ties and feel comfortable may be as important as not smoking.
That’s the dramatic finding in a new study from University of Michigan researchers, who analyzed data from the Health and Retirement study, a nationwide biennial survey that has been ongoing since 1992. A total of nearly 7,000 individuals from communities around the country were included in the stroke study; none of them had had a stroke when the data collection began. The researchers then looked at how an individual’s incidence of stroke correlated with his or her “perceived neighborhood cohesion.”
The data showed that people who felt connected to their neighbors had significantly fewer strokes than those who felt alienated. When researchers compared respondents who reported the highest neighborhood cohesion to those who reported the lowest connection, there was a 48 percent difference in the number of people who had a first stroke and those who didn’t. The results were then adjusted to account for other known risk factors.
“It’s the same difference as between a current smoker and someone who never smoked,” says Eric Kim, the lead author on the paper published in the journal Social Science and Medicine. “I was personally surprised.” His group’s findings reinforced an earlier study that showed greatly reduced risk of stroke mortality among people living in cohesive neighborhoods.
Respondents to the survey self-rated their neighborhood’s cohesiveness by rating their agreement with four statements on a scale of one to seven: “I really feel part of this area,” “Most people in this area can be trusted,” “If you were in trouble, there are lots of people in this area who would help you,” and “Most people in this area are friendly.”
The study’s subjects came from different types of communities around the country – rural, suburban, and urban – without regard to whether any particular physical type of neighborhood fostered good feeling among its residents.
Kim, a doctoral student in Michigan’s psychology department, says that previous research on strokes has mostly focused on the “person-level” risks, such as smoking, exercise, and diet. And researchers have also examined the negative health effects of neighborhood factors such as violence, noise, traffic, litter, low neighborhood socioeconomic status, and poor air quality.
This new study, however, adds to a growing body of research that looks at the positive health effects of living in a well-connected and socially supportive environment. The results resonate, says Kim, with some other observations that have come to light in recent years, including the wide geographic variance in the death toll from Chicago’s 1995 heat wave. In that case, as Eric Klinenberg wrote in his book Heat Wave: A Social Autopsy of Disaster in Chicago, residents of a tightly knit, dense Latino neighborhood saw fewer deaths than African American residents of a neighborhood where the income levels were similar, but where the streets had been emptied out by years of disinvestment and decay.
Kim thinks further research could show whether the physical characteristics of a neighborhood might foster (or hinder) the sense of connectedness that leads to a lower incidence of stroke, or how neighborhood norms can create incentives for better habits.
Stroke is a big risk for the nation’s aging population, and a leading cause of disability. It affects some 7 million Americans, with nearly 800,000 new cases reported each year. Much of that suffering could potentially be prevented, this study suggests, if we had more neighborhoods where people feel truly at home.