Perceived vs. objective reality: investigating predictors of perceived availability of health-promoting neighbourhood facilities

Both the objective and perceived environment (including neighbourhood facilities) play an important and independent role in citizens’ health. Perceived facility availability, however, is not perfectly predicted by objective availability. More research is needed on what other factors influence perceived availability. Using multilevel model analysis, we controlled for neighbourhood objective availability, to identify citizens’ characteristics that predict the perceived availability of three types of health-promoting facilities: medical care, green spaces and sports. We used a large city-wide survey completed by 13,918 respondents across all 71 neighbourhoods together with objective neighbourhood data. We found age, gender, education, employment, living with partner, children present in household, financial stress and Dutch illiteracy to predict the perceived availability of facilities independently from objective availability, where predictors differ across the three types of facilities. Financial stress was the strongest and only constant predictor, with citizens under financial stress perceiving all three types of facilities to be less available. Policymakers should increase awareness and actively encourage the use of available health-promoting facilities, particularly among citizens coping with financial stress, to ensure equitable access to these resources. Without those efforts, those who stand to benefit most from these resources may fail to do so.