Life Course Neighborhood Socioeconomic Disadvantage and Chronic Disease Accumulation in Mid- to Late Adulthood.

Abstract

ObjectiveThis study examines associations between neighborhood socioeconomic disadvantage during adolescence and early adulthood and chronic disease accumulation in mid- to late life.MethodsUsing Panel Study of Income Dynamics data linked to U.S. Census and American Community Survey data, we identify four trajectories of neighborhood disadvantage, namely persistent disadvantage, increasing disadvantage, decreasing disadvantage, and persistent advantage, and estimate their associations with chronic and cardiometabolic conditions diagnosed between ages 40 and 75.ResultsCompared with persistent neighborhood advantage, persistent and increasing disadvantage are associated with chronic disease burden, net of individual and contemporaneous neighborhood socioeconomic conditions. Associations between decreasing disadvantage and multimorbidity are largely attenuated after adjustment for individual socioeconomic characteristics.ConclusionsPersistent neighborhood disadvantage is associated with greater chronic disease accumulation, while worsening disadvantage is particularly associated with cardiometabolic burden, highlighting the relevance of earlier-life inequality for aging. Adolescence and early adulthood may represent sensitive periods, with early adulthood potentially more consequential for chronic disease burden.