The Importance of the Neighborhood in the 2014 Ebola Outbreak in the United States: Distress, Worry, and Functioning

Objective: Ebola media coverage directed public attention to potential disease carriers: residents or travelers from West Africa. We investigated the role of neighborhood population factors (i.e., the concentration of West African foreigners, non-West African foreigners, non-Hispanic Blacks) on individual responses to the Ebola outbreak in the United States. The role of these community-level factors in emotional responses to this public health crisis is poorly understood. Method: Demographic factors, mental health, and stressful event history, collected as part of an ongoing longitudinal study of residents from 2 metropolitan communities (New York City and Boston, total N = 1,346), were combined with neighborhood data from the U.S. Census. Multilevel models estimated the effects of individual and neighborhood factors on individual psychological distress, functional impairment, and Ebola-related worry. Results: Individuals living in neighborhoods with more West African-born foreigners or non-West African foreigners reported more somatization and anxiety symptoms, functioning difficulties, and/or Ebola-related worry than individuals living in neighborhoods with fewer foreign residents (p = .05). Individuals residing in neighborhoods with more non-Hispanic Blacks also reported more somatization symptoms than their residential counterparts (p = .05). Conclusion: Neighborhood demography is important to study during a public health outbreak like Ebola in which media and policy target specific people or regions. Findings suggest research and policies should not only assist at-risk individuals but also at-risk neighborhoods during and after an infectious disease crisis.