title: Neighborhood socioeconomic context and change in allostatic load among older Puerto Ricans: The Boston Puerto Rican health study.
abstract: Neighborhood context may influence health and health disparities. However, most studies have been constrained by cross-sectional designs that limit causal inference due to failing to establish temporal order of exposure and disease. We tested the impact of baseline neighborhood context (neighborhood socioeconomic status factor at the block-group level, and relative income of individuals compared to their neighbors) on allostatic load two years later. We leveraged data from the Boston Puerto Rican Health Study, a prospective cohort of aging Puerto Rican adults (aged 45-75 at baseline), with change in AL modeled between baseline and the 2nd wave of follow-up using two-level hierarchical linear regression models. Puerto Rican adults with higher income, relative to their neighbors, exhibited lower AL after two years, after adjusting for NSES, age, gender, individual-level SES, length of residence, and city. After additional control for baseline AL, this association was attenuated to marginal significance. We found no significant association of NSES with AL. Longitudinal designs are an important tool to understand how neighborhood contexts influence health and health disparities.
authors.affiliation: Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, USA.
authors.forename: Marcia P
authors.initials: MP
authors.lastname: Jiménez
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, West Bank Office Building, Suite 435, 1300 S. Second Street, Minneapolis, MN 55454, USA.
authors.forename: Theresa L
authors.initials: TL
authors.lastname: Osypuk
authors.affiliation: Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts at Lowell, 3 Solomont Way, Suite 4, Lowell, MA 01854, USA; Center for Population Health and Health Disparities, University of Massachusetts at Lowell, Weed Hall 3 Solomont Way, Suite 4, Lowell, MA 01854, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Arevalo
authors.affiliation: Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts at Lowell, 3 Solomont Way, Suite 4, Lowell, MA 01854, USA; Center for Population Health and Health Disparities, University of Massachusetts at Lowell, Weed Hall 3 Solomont Way, Suite 4, Lowell, MA 01854, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
authors.affiliation: College of Fine Arts, Humanities, & Social Sciences, University of Massachusetts at Lowell, 150 Wilder St., Lowell, MA 01854, USA; Center for Population Health and Health Disparities, University of Massachusetts at Lowell, Weed Hall 3 Solomont Way, Suite 4, Lowell, MA 01854, USA.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Falcon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052636:Allostasis / Q000502:physiology*; D001900:Boston; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011647:Puerto Rico / Q000208:ethnology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012923:Social Class
keywords: Allostatic load; Neighborhood context; Puerto Ricans; Relative income