title: Neighborhoods and disability in later life.
abstract: This paper uses the US Health and Retirement Study to explore linkages between neighborhood conditions and stages of the disablement process among adults aged 55 years and older in the United States. We consider multiple dimensions of the neighborhood including the built environment as well as social and economic conditions. In doing so, we use factor analysis to reduce indicators into eight neighborhood scales, which we incorporate into two-level logistic regression models along with controls for individual-level factors. We find evidence that economic conditions and the built environment, but not social conditions, matter. Neighborhood economic advantage is associated with a reduced risk of lower body limitations for both men and women. We also find for men that neighborhood economic disadvantage is linked to increased chances of reporting personal care limitations, particularly for those aged 55-64 years, and that high connectivity of the built environment is associated with reduced risk of limitations in instrumental activities. Our findings highlight the distinctive benefits of neighborhood economic advantage early in the disablement process. In addition, findings underscore the need for attention in the design and evaluation of disability-prevention efforts to the benefits that accrue from more physically connected communities and to the potential harm that may arise in later life from living in economically disadvantaged areas.
authors.affiliation: Department of Health Systems and Policy, University of Medicine and Dentistry of New Jersey-School of Public Health, 335 George Street, Suite 2200, New Brunswick, NJ 08903, USA. vfreedman@umdnj.edu
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Freedman
authors.forename: Irina B
authors.initials: IB
authors.lastname: Grafova
authors.forename: Robert F
authors.initials: RF
authors.lastname: Schoeni
authors.forename: Jeannette
authors.initials: J
authors.lastname: Rogowski
mesh_terms: D000375:Aging; D006233:Persons with Disabilities / Q000145:classification / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012924:Social Conditions; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology