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Original research
Concentrated disadvantage and functional disability: a longitudinal neighbourhood analysis in 100 US cities
  1. Daniel Semenza1,2,
  2. Ian Silver3,
  3. Richard Stansfield1,
  4. Courtney Boen4
  1. 1 Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, New Jersey, USA
  2. 2 Urban-Global Public Health, Rutgers University, Piscataway, New Jersey, USA
  3. 3 Center for Courts and Corrections Research, Research Triangle Institute, Research Triangle Park, North Carolina, USA
  4. 4 Sociology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Daniel Semenza, Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ 08102, USA; Daniel.semenza{at}rutgers.edu

Abstract

Background Socioeconomic disadvantage related to poverty, unemployment and social disinvestment contributes to significant disparities in community health in the USA. Yet, there remains limited ecological research on the relationship between neighbourhood disadvantage and functional disability. Much of the work in this area has focused on elderly populations without attention to variation across age and sex groups.

Methods Using a longitudinal dataset of almost 16 000 neighbourhoods, we examine the relationship between neighbourhood disadvantage and functional disability. Leveraging a series of cross-lagged panel models, we account for reciprocal dynamics and a range of pertinent covariates while assessing differences across age- and sex-specific groups.

Results Accounting for reciprocal effects, we found that the association between concentrated disadvantage and functional disability varies across age and sex groups. Concentrated disadvantage is most consistently associated with increased functional disability among boys (5–17 years), young men (18–34 years) and middle-aged men (35–64 years). Similar associations are found among girls (5–17 years) and middle-aged women (35–64 years).

Conclusion Local neighbourhood economic conditions are significantly associated with functional disability among relatively young populations of males and females. Exposure to neighbourhood disadvantage and deprivation may accelerate disablement processes and shift the age curve of disability risk.

  • Concentrated disadvantage
  • functional disability
  • community health
  • age
  • sex

Data availability statement

Data are available upon reasonable request.

http://dx.doi.org/10.1136/jech-2023-220487

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Twitter @dsemenzcrim

    • Contributors DS acts as the guarantor and was responsible for data collection, conceptualisation, writing, analysis assistance and editing. IS was responsible for statistical analysis, writing and editing. RS was responsible for data collection, conceptualisation, writing, analysis and editing. CB was responsible for writing, editing and manuscript submission assistance.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.