The stress pathway posits that those in disadvantaged circumstances are exposed to a higher degree of stressful experiences over time resulting in an accumulated biological burden which subsequently relates to poorer health. Trajectories of disadvantage, in the form of neighbourhood deprivation and structural social capital, are evaluated in their relation to allostatic load representing the cumulative “wear and tear” of chronic stress. This paper uses data from the British Household Panel Survey and Understanding Society in a latent class growth analysis. We identify groups of exposure trajectories over time using these classes to predict allostatic load at the final wave. The results show that persistent exposure to higher deprivation is related to worse allostatic load. High structural social capital over time relates to lower allostatic load, in line with a stress buffering effect, though this relationship is not robust to controlling for individual sociodemographic characteristics. By demonstrating a gradient in allostatic load by histories of deprivation, this analysis supports a biological embedding of disadvantage through chronic exposure to stressful environments as an explanation for social health inequalities.

Investigating biologically plausible mechanisms for the embodiment of context is a key thoroughfare for progressing health geographies of place. Expanding knowledge of bio-processes such as epigenetics is providing a platform for appreciating the dynamic embedding of social relations in bodies over the lifecourse, and so to tracing the development of health inequalities. By providing a geographic lens on the biosocial, health geographers have key contributions to make regarding the theorisation of place. We put forward the exposome as a holistic framework in which to situate a biosocial health geography, placing ideas of dynamic exposure, plasticity and temporality as central.

Deprived neighbourhoods have long been associated with poorer health outcomes. However, many quantitative studies have not evidenced the mechanisms through which place 'gets under the skin' to influence health. The increasing prevalence of biosocial data provides new opportunities to explore these mechanisms and incorporate them into models of contextual effects. The stress pathway is a key biosocial mechanism; however, few studies have explicitly tested it in neighbourhood associations. This paper addresses this gap by investigating whether allostatic load, a biological response to chronic stress, mediates relationships of neighbourhood deprivation to physical and mental health. Data from UK Understanding Society is used to undertaken a multilevel mediation analysis. Allostatic load is found to mediate the association between neighbourhood deprivation and health, substantiating the biological mechanism of the stress pathway. More deprived areas are associated with higher allostatic load, and in turn worse allostatic load relates to poorer physical and mental health. Allostatic load is a stronger mediator of physical health than mental health, suggesting the stress pathway is more pertinent to explaining physical health gradients. Heterogeneity in the results between physical and mental health suggests more research is needed to disentangle the biosocial processes that could be important to health and place relationships.

Analyses of health over time must consider the potential impacts of ageing as well as any effects relating to cohort differences. The British Household Panel Survey (BHPS) and Understanding Society longitudinal studies are employed to assess trends in mental ill-health over a 26-year period. This analysis uses cross-classified multilevel models in an exploratory, nonparametric approach to evaluate age and cohort effects net of each other. Mental ill-health evidences an initial worsening trend as people age which then reverses and exhibits improvement in late-middle-age, before declining again in the latter stages of life. There were less defined cohort trends. The modelling technique also reveals the relative importance of the temporal contexts in relation to inter-and intra-individual effects on mental ill-health, demonstrating that the ageing and cohort dimensions explain little variation compared to these more dominant within and between influences. Ultimately, we suggest that researchers would benefit from wider use of this exploratory modelling strategy when evaluating underlying health trends and more research is now needed to explore potential explanations of these baseline trajectories.

Education systems around the world increasingly rely on school value-added models to hold schools to account. These models typically focus on a limited number of academic outcomes, failing to recognise the broader range of non-academic student outcomes, attitudes and behaviours to which schools contribute. We explore how the traditional multilevel modelling approach to school value-added models can be extended to simultaneously analyse multiple academic and non-academic outcomes and thereby can potentially provide a more rounded approach to using student data to inform school accountability. We jointly model student attainment, absence and exclusion data for schools in England. We find different results across the three outcomes, in terms of the size and consistency of school effects, and the importance of adjusting for student and school characteristics. The results suggest the three outcomes are capturing fundamentally distinct aspects of school performance, recommending the consideration of non-academic outcomes in systems of school accountability.