The price of access: capitalization of neighborhood contextual factors

Background: Studies of neighborhood context on health behavior have not considered that the health benefits of context may be 'capitalized' into, or included in, higher housing values. This study examines the associations of better neighborhood context with neighborhood housing values. Methods: We use the third wave of Add Health (2000-2001) to estimate the association of neighborhood contextual variables and housing values first across then within income types. This is a census block group-level analysis. Results: We find that neighborhood context, especially access to fruit and vegetable outlets, is capitalized into, or associated with, higher housing values. Fast food and convenience store access are associated with lower housing values. Capitalization differs by income quartile of the neighborhood. Even those in the poorest neighborhoods value access to fresh fruits and vegetables, and those in the wealthier neighborhoods value activity resources. All neighborhood incomes types place negative value on fast food access and convenience store access. Conclusions: Access to health-related contextual attributes is capitalized into higher housing prices. Access to fresh fruits and vegetables is valued in neighborhoods of all income levels. Modeling these associations by neighborhood income levels helps explain the mixed results in the literature on the built environment in terms of linking health outcomes to access.