Cumulative Exposure to Neighborhood Context

Abstract

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.

Neighborhood disadvantage and physical aggression in children and adolescents: A systematic review and meta‐analysis of multilevel studies

“…Consistent with our predictions, the association between neighborhood disadvantage and physical aggression was stronger with longer study periods. This may have been caused by cumulative exposure to disadvantaged neighborhoods, which increased the adverse effects of disadvantage (Clarke et al, 2014). In a longitudinal study, Wodtke et al (2011) followed 4,154 participants aged 1-17 years, and found that sustained exposure to disadvantaged neighborhoods had a more profound impact than the effects apparent in studies with short follow-up periods.…”

Neighborhood-health links: Differences between rural-to-urban migrants and natives in Shanghai

“…Many studies have documented significant associations between objective or subjective neighborhood factors and individual health outcomes, net of personal characteristics (see Balfour and Kaplan 2002;Clarke et al 2014;Diez Roux 2001;Do et al 2008;Ellaway, Macintyre, and Kearns 2001;Kawachi and Berkman 2003;Siordia and Saenz 2013;Wen, Hawkley, and Cacioppo 2006;Weden, Carpiano, and Robert 2008;Yen et al 2008). For example, the availability of recreational parks and bus routes has been found to be positively associated with levels of physical activity participation, thus indirectly promoting health.…”

Where there's smoke: Cigarette use, social acceptability, and spatial approaches to multilevel modeling

“…The primary contextual factors examined in many multilevel studies are those associated with economic advantage and disadvantage (see e.g., Brooks-Gunn, Duncan, and Aber 1997; Clarke et al 2014). The role of local socioeconomic status (SES) in shaping the health of all residents is an important connection to address – it is consistently influential across outcomes, and may shape health through a myriad of pathways.…”