NEIGHBORHOOD EFFECTS ON HEALTH: Exploring the Links and Assessing the Evidence INGRID GOULD ELLEN, TOD MIJANOVICH, and KERI-NICOLE DILLMAN New York University ABSTRACT: This article explores the possible causal pathways through which neighbor- hoods might affect health and then reviews the existing evidence. Although methodological issues make the literature inconclusive, the authors offer a provisional hypothesis for how neighborhoods shape health outcomes. They hypothesize that neighborhoods may primar- ily influence health in two ways: first, through relatively short-term influences on behav- iors, attitudes, and health-care utilization, thereby affecting health conditions that are most immediately responsive to such influences; and second, through a longer-term process of “weathering,” whereby the accumulated stress, lower environmental quality, and limited resources of poorer communities, experienced over many years, erodes the health of resi- dents in ways that make them more vulnerable to mortality from any given disease. Finally, drawing on the more extensive research that has been done exploring the effects of neigh- borhoods on education and employment, the authors suggest several directions for future research. T here is broad consensus that residents of socially and economically deprived communities experience worse health outcomes on average than those living in more prosperous areas. Stud- ies have found that residents of poorer areas suffer from higher rates of heart disease, respi- ratory ailments, cancer, and overall mortality (Adler, Boyce, Chesney, Folkman, & Syme, 1993; Crombie, Kenicer, Smith, & Tunstall-Pedoe, 1989; Devesa & Diamond, 1983; Harburg, Er- furt, Chape, Hauenstein, Schull, & Schork, 1973; Jenkins, 1983). Research also suggests that in poorer neighborhoods mothers are more prone to deliver low birth weight babies, infants are more likely to die in their first year of life, and children are more likely to be hospitalized for asthma and be victims of violence (Corn, Hamrung, Ellis, Kalb, & Sperber, 1995; Coulton & Pandey, 1992; Garbarino, Dubrow, Kostelny, & Pardo, 1992; Guest, Almgren, & Hussey, 1998; Stockwell & Wicks, 1984). *Direct correspondence to: Ingrid Gould Ellen, Wagner Graduate School of Public Service, New York University, 4 Washington Square North, New York, NY 10003. E-mail: ige2@nyu.edu JOURNAL OF URBAN AFFAIRS, Volume 23, Number 3-4, pages 391–408. Copyright © 2001 Urban Affairs Association All rights of reproduction in any form reserved. ISSN: 0735-2166.