(Un)healthy lifestylesEducation as a dividing line

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The neighbourhood and health-related behaviour

Authors: Stéfanie André, Roza Meuleman and Gerbert Kraaykamp

The social setting can be an important factor in understanding health-related habits and preferences; see also Education as a dividing line. The social setting may consist of the respondent’s immediate family or circle of friends, but can also often include living in particular neighbourhoods (Carpiano 2007; Van Lenthe & Mackenbach 2006). The immediate and day-to-day residential setting is important because it gives an indication of the availability of facilities. It also provides an idea of what is usual in terms of the health-related behaviour of those surrounding an individual (Carpiano 2007). In this card we therefore seek to determine whether there are substantial differences between neighbourhoods in terms of the six health-related lifestyle indicators. More specifically, we want to explore whether the quality of the residential environment influences the health-related behaviour of residents and what role educational differences play in that process.

Quality of the residential environment: population density

As an indicator of the quality of the residential setting, we look first at the population density (number of persons per square kilometre) in a neighbourhood. In more densely populated neighbourhoods, there are fewer opportunities on average to engage in physical activity outdoors and more temptations to unhealthy behaviour (ready availability of fast food, supermarkets, etc.).
Second, we look at the percentage of owner-occupied homes in a neighbourhood. Neighbourhoods with a high proportion of owner-occupied homes generally experience less crime, are better maintained, suffer less from decay and neglect, have a wide range of amenities and enjoy greater social cohesion (Rohe et al. 2013). The number of respondents for this card is slightly lower than in the previous cards (1,369 versus 1,415) .

Healthy behaviour and the neighbourhood

Population density
First of all, we find (figure 7.1) that engaging in sufficient physical activity is less common in more densely populated neighbourhoods. The more people per square kilometre living in a neighbourhood, the lower the percentage of residents who engage in physical activity for 30 minutes on at least one day per week.

Around 85% of those living in sparsely populated neighbourhoods are physically active, compared with 79% in intermediately and densely populated neighbourhoods. This is very likely connected to the availability of outdoor space in densely populated neighbourhoods, with fewer opportunities for physical activity. However, it could also be linked to the population profile of the neighbourhood. Wider availability of public transport in more urbanised neighbourhoods could also mean that residents less often use a bicycle, for example.

Neighbourhood context and composition

We are not able to distinguish here between context (what the neighbourhood looks like) and composition (which people live in a neighbourhood). We will focus on this in a later publication.

Figure 7.1Physical activity by population density of neighbourhood

low population density 85
medium 79,2
high population density 79,6

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,369)

Educational differences
The fact that people in neighbourhoods with low population density more often engage in intensive physical activity than residents of densely populated neighbourhoods applies across all educational groups (figure 7.2). Interestingly, the neighbourhood differences in terms of education are not especially pronounced; the pattern is more or less the same for all degrees of urbanisation. Even in the most highly urbanised setting, 90.5% of highly educated residents engage in intensive physical activity at least once per week. In the least urbanised neighbourhoods, the figure is 98.4% – a relatively small difference. The differences are comparable for the other educational groups. We therefore conclude that neighbourhood characteristics do not have a strong influence on educational inequality in health-related behaviour in this instance.

Figure 7.2Exercise by population density and educational level

low higher secondary higher professional (HBO) university (WO)
low population density 77,8 87,5 86,1 98,4
medium 69,2 79,8 86,4 96,5
high population density 70 82,6 80 90,5

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,369)

Eating vegetables
We also find educational differences based on population density in relation to daily consumption of vegetables (figure 7.3). Highly educated people living in neighbourhoods with a lower population density eat less healthy than their counterparts in neighbourhoods with an average population density. The gap compared with low-educated residents is 4.7 percentage points in neighbourhoods with a low population density, while in densely populated neighbourhoods it is no less than 17 percentage points. Determining whether these differences are due to a selective influx of residents with relatively unhealthy habits or whether it is the neighbourhood that reinforces or suppresses health-related behaviour requires further research.

Figure 7.3Daily vegetable consumption by population density and educational level

low higher secondary higher professional (HBO) university (WO)
low population density 73,4 73 84,4 78,1
medium 70,2 76,1 83,3 92,8
high population density 70,9 84,3 84 87,9

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,369)

Quality of the residential environment: homogeneous or heterogeneous neighbourhoods?

Alcohol consumption
Figure 7.4 portrays regular alcohol consumption and relates it to the prosperity of the neighbourhood where someone lives. The assumption is that people in more affluent neighbourhoods will take more care of the physical and social setting, which may promote healthier behaviour. The pattern found earlier where university graduates most often drink alcohol regularly, in Health-related behaviour in the Netherlands, is repeated here. University graduates from neighbourhoods with a high proportion of owner-occupied houses, and also those from neighbourhoods with virtually no owner-occupied houses, are particularly likely to drink regularly (66.8% and 63.8%, respectively). The educational differences are much less pronounced in neighbourhoods with a more balanced distribution of owner-occupied and rented houses. The education gap in alcohol consumption is thus greatest in homogeneous neighbourhoods with a predominance of owner-occupied or rented houses.

Figure 7.4Regular alcohol consumption by percentage of owner-occupied houses in the neighbourhood and educational level

Koopwoningen low higher secondary higher professional (HBO) university (WO)
0-25% 17,8 46,1 30,9 63,8
26-50% 31,5 31,5 39,8 50,2
51-75% 31,9 44,4 40,7 29
76-100% 45,2 46,2 47,3 66,8

Source:European Social Survey Netherlands, Round 7, 2014-2015 (N=1,369)

Eating fruit
Figure 7.5 shows that the education gap as regards eating fruit daily is greatest in neighbourhoods with few owner-occupied houses. In other words, the less affluent a neighbourhood is, the greater the differences in fruit consumption between those with a low and high educational level, with those with a high educational level more often eating fruit daily than low-educated residents. People with a low educational level thus appear to adopt more healthy behaviour in affluent neighbourhoods and eat relatively healthy, perhaps because of the greater opportunities and seeing more healthy examples. Further research is needed to ascertain to what extent structural and cultural neighbourhood characteristics may reinforce or weaken lifestyle habits.

Figure 7.5Daily consumption of fruit by percentage of owner-occupied houses in the neighbourhood and level of education

Koopwoningen low higher secondary higher professional (HBO) university (WO)
0-25% 48,5 83,9 75,3 88,3
26-50% 58 66,8 68,4 74,1
51-75% 74,7 72 75 63,7
76-100% 68,3 66,3 71,4 85,8

Source:EC/NWO (ESS Netherlands 2014/’15, Round 7) (n = 1369)


Carpiano, R.M. (2007). Neighborhood social capital and adult health: an empirical test of a Bourdieu-based model. In: Health & Place, vol. 13, no. 3, pp. 639-655.

Rohe, W.M., S. Van Zandt & G. McCarthy (2013). The social benefits and costs of homeownership. A critical assessment of the research. In: The Affordable Housing Reader, vol. 40, pp. 196-213.

Cite this card

André, S., R. Meuleman and G. Kraaykamp (2018). The neighbourhood and health-related behaviour. In: (Un)healthy lifestyles: Education as a dividing line. Retrieved [datum vandaag] from https://digital.scp.nl/lifestyles/the-neighbourhood-and-health-related-behaviour.

Information notes

This is because neighbourhood data are not available on all neighbourhoods from ESS Round 7 via Statistics Netherlands (CBS).