Neighborhood social cohesion and posttraumatic stress disorder in a community-based sample: findings from the Detroit Neighborhood Health Study

Posttraumatic stress disorder (PTSD) is common and debilitating. Although research has identified individual-level risk factors
for PTSD, the role of macro-social factors in PTSD etiology remains unknown. This study tests whether perceived neighborhood
social cohesion (NSC), measured at the both the individual and neighborhood levels, plays a role in determining past-year
risk of PTSD among those exposed to trauma.

Data (n = 1,221) were obtained from an ongoing prospective epidemiologic study in the city of Detroit. Assessment of traumatic event
exposure and PTSD was consistent with DSM-IV criteria. Generalized estimating equations (GEE) and logistic regression models
were used to estimate the association of neighborhood-level perceived NSC with the risk of PTSD, adjusting for individual-level
perceptions of NSC and other covariates.

The odds of past-year PTSD were significantly higher among those residing in a neighborhood with low social cohesion compared
to high (OR = 2.44, 95 % CI: 1.58, 3.78), independent of individual sociodemographic characteristics, number of traumas, and
individual-level perceptions of NSC. The odds of past-year PTSD were not significantly associated with individual-level perceptions
of NSC.

These results demonstrate that social context shapes risk of PTSD and suggest that changing the social context may shift vulnerability
to this disorder.