Perceived Neighborhood Social Cohesion and Stroke

The Issue:

The impact of negative neighborhood factors on health has been examined, yet few studies examine the ways in which neighborhood factors may positively impact health. This study specifically looks at the relationship between higher perceived neighborhood social cohesion and stroke incidence.

Key Findings

  • Over a four-year follow-up, higher perceived neighborhood social cohesion was associated with a lower risk of stroke, even after adjusting for covariates.

  • Each standard deviation increase in perceived neighborhood social cohesion was associated with a 15 percent reduced risk in stroke incidence.

  • These findings were significant after adjusting for age, gender, chronic illnesses, marital status, education, and total wealth.


Perceived neighborhood social cohesion and physical health may play an important role in protecting against stroke. More research is needed to better understand the relationship between social cohesion and stroke to identify creative public health approaches to stroke prevention.

About the Study:

Using data from the Health and Retirement Study (HRS), a nationally representative panel study of American adults over the age of 50, this study included 6,740 respondents who were stroke-free at baseline. The study assessed the odds of stroke incidence over a four-year period, including data from 2006, 2008, 2010, and exit interviews. A four-item scale assessed the perceived social cohesion and perceived social trust of the respondent’s neighborhood.

This study is one in a series supported by the Robert Wood Johnson Foundation’s Pioneer Portfolio to explore Positive Health, an emerging concept that seeks to demonstrate that in addition to health risks, people also have health assets, which can be strengthened to produce a healthier life. These health assets could include biological factors, such as high heart rate variability; subjective factors, such as optimism; and functional factors, such as a stable marriage.