Neighbourhood influences on health in Montréal, Canada

Nancy A. Ross, , a, Stéphane Tremblayb and Katie Grahama

a Department of Geography, McGill University, 805 Sherbrooke St. West,
Montréal, Que., Canada H3A 2K6
b Health Analysis and Measurement Group, Statistics Canada, R.H. Coats
Bldg, 24th Floor, Ottawa Ont., Canada K1A 2T6

Available online 10 March 2004.

Abstract
This paper examines neighbourhood effects on health within a large Canadian
city—Montréal. Our approach is to consider that individual health outcomes
are determined both by individual and neighbourhood characteristics and we
consciously take on the problem of neighbourhood definition by developing
‘natural’ neighbourhoods. Our data come from the Montréal health region
sample of the 2000/1 Canadian Community Health Survey, a comprehensive
national survey that contains information on health outcomes as well as
behavioural and socio-demographic information. Respondents were placed into
‘naturally’ defined neighbourhoods as opposed to arbitrary geostatistical
units, responding to calls in the literature to develop more meaningful
units of analysis. We also compare the ‘natural’ neighbourhood approach
with the use of standard census tracts as the unit of analysis. Results
show significant between-neighbourhood variation in health status with
about 3% of the variance in the Health Utilities Index captured at the
neighbourhood level, even after controlling for a variety of
socio-demographic and behavioural variables at the individual level. Models
using census tracts as the unit of analysis had remarkably similar results
to the ‘natural’ neighbourhood models, suggesting that census tracts are
good proxies for natural neighbourhood boundaries in studies of
neighbourhood effects on health.

Author Keywords: Neighbourhood characteristics,‘Natural’
neighbourhoods,Health Utilities Index

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