Using a longitudinal cohort, we assessed the association between neighborhood disadvantage and incidence of poor health and function in three domains.
Over 4,000 enrollees aged 55–65 in the national Health and Retirement Study were assessed biennially from 1998 through 2006 for incidence of: fair/poor self-rated health (SRH), elevated depressive symptoms, and limitations in five basic Activities of Daily Living (disability). Each analysis was restricted to subjects without that condition in 1994 or 1996. Neighborhoods (census tracts, time-updated for moves), were considered disadvantaged if they fell below the 25th percentile in an index comprising 6 socioeconomic status indicators. Repeated measures logistic regressions, inverse probability weighted to account for individual confounders, selective survival, and loss to follow-up, were used to estimate odds ratios (ORs) for incidence of each outcome in the wave following exposure to disadvantaged neighborhood.
After covariate adjustment, neighborhood disadvantage predicted onset of fair/poor SRH (OR=1.32; 95% confidence interval 1.11, 1.57), but not disability (OR=0.98; 0.82, 1.16) or elevated depressive symptoms (OR=0.98; 0.83, 1.16).
Results confirmed prior findings that neighborhood disadvantage predicts SRH in a longitudinal context, but did not support an association between neighborhood disadvantage and onset of disability or elevated depressive symptoms.