Neighborhood Social Cohesion, Physical Disorder, and Multiple Chronic Conditions in Older Adults: An Examination of Racial/Ethnic Differences.

Abstract

This study examines how neighborhood social cohesion and physical disorder, measured at baseline and as change over time, are associated with multiple chronic conditions (MCCs) among older adults and whether these associations vary by race/ethnicity. Using 6 years of data from the National Health and Aging Trends Study (2015-2021), mixed-effects Poisson regression models were applied to a sample of 3,389 community-dwelling older adults. Higher social cohesion at baseline and increases in cohesion over time were associated with greater MCC burden. No significant associations were found for physical disorder, either at baseline or in changes over time. A significant interaction indicated that non-Hispanic Black older adults had lower MCC scores than non-Hispanic White adults in neighborhoods with higher baseline levels of physical disorder. No significant interactions were observed for social cohesion. It highlights the importance of public health strategies that combine environmental improvements with culturally responsive approaches to address group-specific resilience.