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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.

Key Points Question What are the associations of the COVID-19 pandemic with career development and what are the work culture and childcare needs of employees and trainees? Findings In this survey study, most participants with children did not have childcare fully available and many considered leaving the workforce and were worried about their career. Being female with children or having a clinical job role was associated with consideration for leaving the workforce and reducing hours. Meaning These findings suggest that a substantial number of employees and trainees experienced major stress and work disruptions because of the COVID-19 pandemic.

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