Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 185, Issue 9, Pages 765-776Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kww206
Keywords
biomarkers; coarsened exact matching; neighborhoods; transition to adulthood
Categories
Funding
- Robert Wood Johnson Investigator Award in Health Policy Research award
- Eunice Kennedy Shriver National Institute of Child Health and Human Development [P01-HD31921]
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Limitations of extant research on neighborhood disadvantage and health include general reliance on point-intime neighborhood measures and sensitivity to residential self-selection. Using data from the US Census and the 1995-2008 National Longitudinal Study of Adolescent to Adult Health, we applied conventional methods and coarsened exact matching to assess how cardiometabolic health varies among those entering, exiting, or remaining in poor and nonpoor neighborhoods. Within the full sample (n = 11,767), we found significantly higher systolic and diastolic blood pressures among those who entered or consistently lived in poor neighborhoods relative to those who never lived in poor neighborhoods. Obesity was similarly more common among those who originated from poor neighborhoods than among those who originated from nonpoor neighborhoods. Having exited poor neighborhoods was associated with lower systolic blood pressure than was consistent residence in low-income communities. Among the matched sample (n = 9,727), results adjusted for confounders and residential self-selection revealed fewer significant contrasts. Compared with peers who had no neighborhood poverty exposure, those who consistently lived in poor neighborhoods had 46% and 52% higher odds of being obese or hypertensive, respectively. Those who exited neighborhood poverty had significantly higher diastolic blood pressures than those who had never lived in poor neighborhoods. These findings underscore the importance of past as well as current residential circumstances for cardiometabolic health.
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