Unpacking healthy landscapes: Empirical assessment of neighborhood aesthetic ratings in an urban setting

Introduction: Past research has demonstrated the powerful role of neighborhood aesthetics in shaping health promoting processes and health behaviors. Methods: Using a cross-sectional, population-based sample of Denver residents participating in the 2007 Neighborhood Environments and Health Survey (NEHS), we applied spatial regression models to examine the relationship between perceived aesthetic ratings and individual and neighborhood measures of the social and physical environment. Results: Perceived and observed incivilities, perceived walkability, area-level poverty, foreclosures, and greenness were significantly associated with neighborhood aesthetic ratings. In the presence of race/education interaction effect, college educated Hispanics had significantly different aesthetic ratings when compared to non Hispanic Black/Other and non-Hispanic Whites. Conclusion: Interventions which promote active and healthy lifestyles should consider both structural and perceived measures of the built environment, and recognize that interventions should be customized to reflect community-level differences in perceptions and experiences of place.