Cumulative exposure to neighborhood context: consequences for health transitions over the adult life course.
Over the last two decades, research has assessed the relationship between neighborhood socioeconomic factors and individual health. However, existing research is based almost exclusively on cross-sectional data, ignoring the complexity in health transitions that may be shaped by long-term residential exposures. We address these limitations by specifying distinct health transitions over multiple waves of a 15-year study of American adults. We focus on transitions between a hierarchy of health states, (free from health problems, onset of health problems, and death), not just gradients in a single health indicator over time, and use a cumulative measure of exposure to neighborhoods over adulthood. We find that cumulative exposure to neighborhood disadvantage has significant effects on functional decline and mortality. Research ignoring a persons' history of exposure to residential contexts over the life course runs the risk of underestimating the role of neighborhood disadvantage on health.
University of Michigan, Michigan, MI, USA pjclarke@umich.edu.
Philippa
P
Clarke
University of Michigan, Michigan, MI, USA.
Jeffrey
J
Morenoff
University of Michigan, Michigan, MI, USA.
Michelle
M
Debbink
University of Minnesota, Minnesota, MN, USA.
Ezra
E
Golberstein
University of Michigan, Michigan, MI, USA.
Michael R
MR
Elliott
George Washington University, Washington, DC, USA.
Paula M
PM
Lantz
D000328:Adult; D000368:Aged; D005260:Female; D006262:Health / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
functional health; life course; mortality; neighborhood effects; panel data; socioeconomic status