Even after controlling for personal income, education, and occupation, we found that living in a disadvantaged neighborhood is associated with an increased incidence of coronary heart disease.

Data from the nationally representative US National Health and Nutrition Examination Survey (NHANES) III cohort were used to examine the hypothesis that socio-economic status is consistently and negatively associated with levels of biological risk, as measured by nine biological parameters known to predict health risks (diastolic and systolic blood pressure, pulse, HDL and total cholesterol, glycosylated hemoglobin, c-reactive protein, albumin and waist-hip ratio), resulting in greater cumulative burdens of biological risk among those of lower education and/or income. As hypothesized, consistent education and income gradients were seen for biological parameters reflecting cardiovascular, metabolic and inflammatory risk: those with lower education and income exhibiting greater prevalence of high-risk values for each of nine individual biological risk factors. Significant education and income gradients were also seen for summary indices reflecting cumulative burdens of cardiovascular, metabolic and inflammatory risks as well as overall total biological risks. Multivariable cumulative logistic regression models revealed that the education and income effects were each independently and negatively associated with cumulative biological risks, and that these effects remained significant independent of age, gender, ethnicity and lifestyle factors such as smoking and physical activity. There were no significant ethnic differences in the patterns of association between socio-economic status and biological risks, but older age was associated with significantly weaker education and income gradients.

Our results have significant and sobering implications: older Americans face increased disability, and society faces increased costs to meet the health care needs of these disabled Americans.

Telomere length (TL) has been proposed as a marker of mitotic cell age and as a general index of human organismic aging. Short absolute leukocyte telomere length has been linked to cardiovascular-related morbidity and mortality. Our aim was to test whether the rate of change in leukocyte TL is related to mortality in a healthy elderly cohort. We examined a subsample of 236 randomly selected Caucasian participants from the MacArthur Health Aging Study (aged 70 to 79 years). DNA samples from baseline and 2.5 years later were assayed for mean TL of leukocytes. Percent change in TL was calculated as a measure of TL change (TLC). Associations between TL and TLC with 12-year overall and cardiovascular mortality were assessed. Over the 2.5 year period, 46% of the study participants showed maintenance of mean bulk TL, whereas 30% showed telomere shortening, and, unexpectedly, 24% showed telomere lengthening. For women, short baseline TL was related to greater mortality from cardiovascular disease (OR = 2.3; 95% CI: 1.0 - 5.3). For men, TLC (specifically shortening), but not baseline TL, was related to greater cardiovascular mortality, OR = 3.0 (95% CI: 1.1 - 8.2). This is the first demonstration that rate of telomere length change (TLC) predicts mortality and thus may be a useful prognostic factor for longevity.

Objective To assess whether neighbourhood socioeconomic status (NSES) is independently associated with disparities in biological “wear and tear”—measured by allostatic load (AL)—in a nationally representative sample of U.S. adults. Design Cross-sectional study. Setting Population-based U.S. survey, the Third National Health and Nutrition Examination Survey (NHANES III), merged with U.S. Census data describing respondents’ neighbourhoods. Participants 13,184 adults from 83 counties and 1,805 census tracts who completed NHANES III interviews and medical examinations and whose residential addresses could be reliably geocoded to census tracts. Main Outcome Measures A summary measure of biological risk, incorporating nine biomarkers that together represent AL across metabolic, cardiovascular, and inflammatory subindices. Results Being male, older, having lower income, less education, being Mexican-American, and being both Black and female were all independently associated with worse AL. After adjusting for these characteristics, living in a lower SES neighbourhood was associated with worse AL (coeff. = −0.46; CI −0.079, −0.012). The relationship between NSES and AL did not vary significantly by gender or race/ethnicity. Conclusions Living in a lower SES neighbourhood in the United States is associated with significantly greater biological wear and tear as measured by AL, and this relationship is independent of individual SES characteristics. Our findings demonstrate that where one lives is independently associated with AL, thereby suggesting that policies that improve NSES may also yield health returns.

This article updates trends from five national U.S. surveys to determine whether the prevalence of activity limitations among the older population continued to decline in the first decade of the twenty-first century. Findings across studies suggest that personal care and domestic activity limitations may have continued to decline for those ages 85 and older from 2000 to 2008, but generally were flat since 2000 for those ages 65–84. Modest increases were observed for the 55- to 64-year-old group approaching late life, although prevalence remained low for this age group. Inclusion of the institutional population is important for assessing trends among those ages 85 and older in particular.

Positive and negative aspects of social relationships are related to cognition throughout adulthood, consistent with the hypothesis that social factors have life-long influences on cognition. Positive and negative aspects of social engagement may thus be important factors to consider in relation to efforts to promote optimal cognitive development and cognitive aging.

PURPOSE To examine race/ethnic specific patterns of association between neighborhood socioeconomic status (NSES) and a cumulative biological risk index in a nationally representative population. METHODS The study sample included 13,199 non-Hispanic white, non-Hispanic black and Mexican American men and women, ages 20 and older, who attended the National Health and Examination Survey examination 1988 and 1994. Neighborhoods were defined as census tracts and linked to US Census measures from 1990 and 2000, interpolated to the survey year; the NSES score included measures of income, education, poverty and unemployment and categorized into quintiles, with the highest indicating greater NSES. A summary biological risk score, allostatic load (AL; range 0-9), was created from nine biological indicators of elevated risk, including serum levels of C-reactive protein, albumin, glycated hemoglobin, total and HDL cholesterol, waist-to-hip ratio, systolic and diastolic blood pressure, and resting heart rate. Regression models stratified by race/ethnicity examined AL as a continuous and dichotomous (high (>=3) vs. low AL) outcome. RESULTS For both outcomes, we found strong inverse associations between NSES and AL for blacks, after adjusting for age, gender, US birth, urbanicity and individual SES. These associations were weaker and less consistent for Mexican Americans and whites. CONCLUSIONS Our results indicate that living in low NSES neighborhoods is most strongly associated with greater cumulative biological risk profiles in the black US population.