Objective exposure to road traffic noise, noise annoyance and self-rated poor health - framing the relationship between noise and health as a matter of multiple stressors and resources in urban neighbourhoods

Borrowing from concepts of socio-environmental epidemiology and psychology, we conceived self-rated health as a function of multiple physical and psychosocial stressors and resources at the residential neighbourhood and individual level. In this model of multiple stressors, objective exposure to road traffic noise was specified as a physical stressor whose effect on health may be mediated and modified by residents' subjective response to noise (serious noise annoyance). Self-reported hearing disability, recreational coping in green areas and residential neighbourhood satisfaction were examined as additional psychosocial stressors or resources, independently of socio-demographic and -economic factors. Results from our empirical analysis based on two studies and multivariable logistic regressions might support the idea that environmental planning should overcome sectoral boundaries and adopt an integrative approach including objective exposures, residents' subjective responses, and perceived resources.