Health & Place 14 (2008) 853–865 Associations of neighborhood problems and neighborhood social cohesion with mental health and health behaviors: The Multi-Ethnic Study of Atherosclerosis Sandra Echeverrı´a a,b,Ã , Ana V. Diez-Roux c , Steven Shea d , Luisa N. Borrell e , Sharon Jackson f a Department of Epidemiology, School of Public Health, University of Medicine and Dentistry of New Jersey (UMDNJ), Piscataway, NJ, USA b Department of Family Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey (UMDNJ), Piscataway, NJ, USA c Department of Epidemiology, University of Michigan School of Public Health, 1214 S. University 2nd Floor, Ann Arbor, MI 48104-2548, USA d Division of General Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA e Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA f Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA Received 9 March 2007; received in revised form 16 January 2008; accepted 17 January 2008 Abstract Few studies have investigated the specific features implicated in neighborhood–health associations. We examined associations between measures of neighborhood problems and neighborhood social cohesion with depression, smoking, drinking, and walking for exercise in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Neighborhoods were characterized according to participant self-report and aggregated measures based on other MESA participants. Individuals living in the least problematic neighborhoods were significantly less likely to be depressed, to smoke, or to drink. Less socially cohesive neighborhoods were associated with increased depression, smoking, and not walking for exercise. Results persisted after adjusting for individual-level variables. Each measure appeared to capture distinct features of the neighborhood and associations did not differ by race/ethnicity. Results for neighborhood problems were robust to the use of aggregate measures but results for social cohesion generally were not. Future work should determine the health effect of modifying specific features of the neighborhood context. r 2008 Elsevier Ltd. All rights reserved. Keywords: Neighborhood characteristics; Measurement; Mental health; Health behaviors Introduction Neighborhood-level deprivation has been consis- tently associated with various health outcomes (Borrell et al., 2004; Bosma et al., 2001; Diehr ARTICLE IN PRESS www.elsevier.com/locate/healthplace 1353-8292/$ - see front matter r 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.healthplace.2008.01.004 Ã Corresponding author. Tel.: +1 732 235 4352; fax: +1 732 235 4814. E-mail address: echevese@umdnj.edu (S. Echeverrı´a).