Neighbourhood effects on self-rated health among adolescents and young adults in the Brussels-Capital Region

This paper will focus on neighbourhood effects on the health status of adolescents and young adults in a European metropolis: Brussels. Contextual effects on health and health behaviour of young persons received much attention in the US, but few is known about its impact in a European context. Brussels is an interesting test case, as it contains sharp socioeconomic discrepancies despite its social welfare regime that offers a good safety net for the disadvantaged. Data are derived from the Belgian census in 2001. It contains information on self-rated health (SRH) and individual characteristics such as nationality, educational level, activity status and household type. Indicators on neighbourhood level include a.o. unemployment rate, proportion of adults with maximum primary education, proportion of single-parent families, mean comfort level of housing and ethnic diversity. Multilevel logistic regression is used to disentangle the association between our contextual indicators and SRH. The Median Odds Ratio is 1.80 [95% CI 1.73-1.87], implying that the heterogeneity between neighbourhoods affects the individual health status of young persons. Our results suggest that contextual indicators of disadvantage contribute to a worse health status of adolescents and young adults, after controlling for several individual measures.