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Neighborhood Socioeconomic Status and Biological “Wear & Tear” in a Nationally Representative Sample of U.S. Adults
  1. Chloe E Bird1,*,
  2. Teresa E Seeman2,
  3. Jose J Escarce1,
  4. Ricardo Basurto-Davila1,
  5. Brian K Finch3,
  6. Tamara Dubowitz1,
  7. Melonie Heron4,
  8. Lauren Hale5,
  9. Sharon Stein Merkin6,
  10. Margaret Weden1,
  11. Nicole Lurie1
  1. 1 RAND Corporation, United States;
  2. 2 Division of Geriatrics, School of Medicine, University of California, United States;
  3. 3 San Diego State University, United States;
  4. 4 Centers for Disease Control and Prevention, United States;
  5. 5 State University of New York - Stony Brook, United States;
  6. 6 University of California, Los Angeles, United States
  1. To whom correspondence should be addressed. E-mail: chloe{at}


Objective: To assess whether neighborhood 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’ neighborhoods.

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 neighborhood 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 neighborhood 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.

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