Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2024.103392
Mariana Lazo , Jingjing Li , Jana A. Hirsch , Kari A. Moore , Amy H. Auchincloss , Loni P. Tabb , Tonatiuh Barrientos-Gutierrez , Jeanne M. Clark , Steven F. Solga , Matt J. Budoff , Brisa N. Sánchez
{"title":"Associations between neighborhood built-environment characteristics and hepatic steatosis: The Multi-Ethnic Study of Atherosclerosis","authors":"Mariana Lazo , Jingjing Li , Jana A. Hirsch , Kari A. Moore , Amy H. Auchincloss , Loni P. Tabb , Tonatiuh Barrientos-Gutierrez , Jeanne M. Clark , Steven F. Solga , Matt J. Budoff , Brisa N. Sánchez","doi":"10.1016/j.healthplace.2024.103392","DOIUrl":"10.1016/j.healthplace.2024.103392","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the spatio-temporal association between features of the built environment and subclinical liver disease.</div></div><div><h3>Design</h3><div>We used data from a large community-based population, the Multi-Ethnic Study of Atherosclerosis (2000–2002, N = 5542) with linked historical residential data that characterized past exposure to alcohol outlets (bars and liquor stores), healthy foods stores, and physical activity facilities (1990–2001). We examined whether and how past residential relate to hepatic steatosis (proxied by liver attenuation measured using computed tomography, with lower attenuation indicating higher hepatic steatosis). Hepatic steatosis is the most common.</div></div><div><h3>Results</h3><div>We found significant associations between past residential exposure to neighborhood alcohol outlets, healthy food and physical activity resources, and hepatic steatosis. The spatial scale where the association between these features of the built environment and hepatic steatosis operate lies within 3 km (∼2 miles). The average association on liver attenuation per additional bar, liquor, healthy food store, and physical activity facility within a 2-mile buffer, were: −0.06 (95% CI -0.09, −0.03), −0.02 (95% CI -0.04, −0.009), 0.05 (95% CI 0.02, 0.07), 0.02 (95% CI 0.01, 0.04), respectively, in the preceding year of the measurement of hepatic steatosis. Furthermore, the association and spatial scale remains consistent ten years prior to the measurement of hepatic steatosis.</div></div><div><h3>Conclusion</h3><div>Our results suggest that modifying neighborhood environments (decreasing alcohol outlets and improving access to healthy food and physical activity) may represent an effective population-wide approach to reduce liver-related morbidity.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103392"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2024.103402
Jennifer Candipan , Karl Vachuska , Brian L. Levy
{"title":"Neighborhood socioeconomic disadvantage and child health: The role of neighborhood mobility networks","authors":"Jennifer Candipan , Karl Vachuska , Brian L. Levy","doi":"10.1016/j.healthplace.2024.103402","DOIUrl":"10.1016/j.healthplace.2024.103402","url":null,"abstract":"<div><div>Despite a large body of work on neighborhood effects on health, past studies are limited in their treatment of neighborhoods as largely static spaces with (dis)advantages based primarily on the average characteristics of their residents. In this study, we draw on the triple neighborhood disadvantage perspective to explore how socioeconomic disadvantage in a neighborhood's mobility network uniquely relates to children’s overall health levels, independent of residential disadvantage. We investigate this by combining 2019 SafeGraph data on mobility patterns from roughly 40 million U.S. mobile devices with information on children, families, and neighborhoods from the 2015-19 American Community Survey and 2019 Panel Study of Income Dynamics Child Development supplement. We find that mobility-based neighborhood disadvantage (MND) generally predicts child health better than residential neighborhood disadvantage (RND), but associations vary by race and by family income and are contingent on the broader metropolitan context. Our study advances existing research on the effects of mobility networks by shifting from analyzing aggregate-level outcomes to exploring how mobility-based disadvantage affects individual outcomes. Overall, our results indicate that the relationship between neighborhood disadvantage and child health is nuanced and complex. Findings from our study suggest that researchers aiming to understand the influence of neighborhood contexts should examine individuals' residential environments as well as the environments of neighborhoods connected through individuals' everyday mobility.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103402"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2024.103404
Yilun Zha
{"title":"The “uneven road” to food: Socioeconomic disparities in the mobility burden of food purchasing behavior in major US cities, 2019–2023","authors":"Yilun Zha","doi":"10.1016/j.healthplace.2024.103404","DOIUrl":"10.1016/j.healthplace.2024.103404","url":null,"abstract":"<div><div>Socioeconomic factors contribute to distinct patterns of food-purchasing behaviors, placing a higher burden of mobility on vulnerable, deprived populations. Traditional approaches often overlook the dynamics of human activity as contextual influences, simulating a perceived food environment that contradicts the actual use thereof. The rise of large-scale mobile phone data presents a unique opportunity to capture real behavioral patterns and their mobility implications at a fine-grained level. Using a Time-Weighted Kernel Density Estimation (TWKDE) model on mobile phone data, this study introduces two novel measures - the Spatial Engel’s Coefficient (SEC) index and the Distance-to-Activity Curve (DAC) – to assess the equity of food-purchasing travel across nine U.S. cities over five years, analyzed by socioeconomic status, time period, and location. Our findings reveal that lower socioeconomic status is strongly associated with greater mobility burdens in food-purchasing travel. This mobility gap between the highest and lowest socioeconomic groups was further exacerbated during the COVID-19 pandemic, manifesting in the form of spatial segregation of opportunities within cities. This paper contributes to the literature by developing novel activity-based tools that offer a more nuanced understanding of the behavioral characteristics of food-purchasing activities. These empirical insights can help policymakers identify the communities facing the greatest mobility burdens and guide targeted, place-based interventions to promote equity in food access.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103404"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2024.103408
Kaitlyn K. Stanhope , Sara Markowitz , Michael R. Kramer
{"title":"Expiration of a state level eviction moratorium in the first or second trimester of pregnancy and perinatal outcomes among Medicaid and uninsured people, 2020–2022","authors":"Kaitlyn K. Stanhope , Sara Markowitz , Michael R. Kramer","doi":"10.1016/j.healthplace.2024.103408","DOIUrl":"10.1016/j.healthplace.2024.103408","url":null,"abstract":"<div><h3>Goal</h3><div>Housing insecurity is associated with poor perinatal outcomes. However, we lack information on whether supportive housing policies improve perinatal health. Our goal was to estimate the effect of expiration of a state-level eviction moratoria on adverse maternal and infant outcomes among Medicaid insured individuals residing in states with a state-level moratorium in place at conception in the United States.</div></div><div><h3>Methods</h3><div>We used data from the US natality files, 2020–2022 and the Eviction Moratoria & Housing Policy dataset to link individuals with moratoria. We compared those for whom the moratorium expired prior to conception, in the first trimester, or second trimester (exposed) with those fully protected through gestation (unexposed) We fit log binomial models to estimated risk ratios (RRs) and 95% confidence intervals (CIs) for each outcome separately (preterm birth (PTB), very preterm birth (VPTB), low birthweight birth (LBW), very low birthweight birth (VLBW), primary cesarean, maternal morbidity, or adequate/adequate plus prenatal care utilization) using generalized estimating equations, controlling for month/year of conception, state (unemployment, monthly covid death rates per 100,000, median household income, governor's party affiliation 2019), and individual (primiparity, age, race/ethnicity) confounders. We also fit difference in difference models as an alternate approach.</div></div><div><h3>Results</h3><div>We included 2,562,067 births (PTB: 12.5%, LBW: 8.1%, primary cesarean:14.1%). All adverse outcomes were more common for births where the moratoria expired prior to conception or during the first trimester. Following adjustment, risk remained significantly elevated for primary cesarean (preconception v. fully protected: RR: 1.08, 95% CI: 1.02, 1.14; first trimester: 1.05, 95% CI: 0.99, 1.11) but not other outcomes. Results from difference in difference models were consistent with multilevel models.</div></div><div><h3>Conclusions</h3><div>Expiration of an eviction moratoria during the first or second trimester of pregnancy was not associated with increased risk of adverse birth outcomes, beyond ongoing state and temporal factors for people birthing in the United States during the COVID-19 global pandemic.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103408"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2024.103405
Richard Patterson , David Ogilvie , Jody C. Hoenink , Thomas Burgoine , Stephen J. Sharp , Samantha Hajna , Jenna Panter
{"title":"Combined associations of takeaway food availability and walkability with adiposity: Cross-sectional and longitudinal analyses","authors":"Richard Patterson , David Ogilvie , Jody C. Hoenink , Thomas Burgoine , Stephen J. Sharp , Samantha Hajna , Jenna Panter","doi":"10.1016/j.healthplace.2024.103405","DOIUrl":"10.1016/j.healthplace.2024.103405","url":null,"abstract":"<div><h3>Background</h3><div>Diet and physical activity are important determinants of energy balance, body weight and chronic health conditions. Peoples’ health and behaviour are shaped by their environment. For example, the availability of unhealthy takeaway food in residential neighbourhoods and the ability to easily walk to a range of local destinations (high “walkability”) influence diets and physical activity levels. Most existing evidence on the associations between residential neighbourhood and adiposity is cross-sectional and examines either walkability or takeaway availability, but not both in combination.We examined the cross-sectional and longitudinal associations of residential neighbourhood walkability and takeaway food availability with markers of adiposity separately and combined.</div></div><div><h3>Methods</h3><div>With data from the Fenland Study (Cambridgeshire, UK; n = 12,435), we used linear regression to estimate associations for walkability and takeaway availability separately and in mutually adjusted models, in addition to combining both into a measure of neighbourhood supportiveness for active living and healthy eating. Objective measures of BMI were examined cross-sectionally at baseline (2005–2015) and as change between baseline and follow-up (2014–2020). Additional outcomes (percentage body fat, waist circumference and hip circumference) were also examined both cross-sectionally and longitudinally.</div></div><div><h3>Results</h3><div>Complete case analyses indicated that neighbourhoods with greater walkability and lower takeaway availability were associated with lower BMI (n = 10,607) and more favourable trends over time (n = 5508). For example, compared with the lowest exposure group (Q1), Q4 of walkability and takeaway food availability was associated with a difference in BMI of −0.69 kg/m<sup>2</sup> (95% CI = −1.09 to −0.29) and 0.99 kg/m<sup>2</sup> (95% CI = 0.58 to 1.39) respectively. These associations were more consistent when both neighbourhood measures were included in mutually adjusted models. The combined supportiveness measure was associated with lower BMI. High walkability and low takeaway availability were also associated with lower body fat percentage, waist circumference and hip circumference.</div></div><div><h3>Conclusions</h3><div>These findings are consistent with the residential environment having a role in shaping people's health and behaviour. Living in an area that supports walking and cycling and affords less access to unhealthy food may support people to maintain a healthy lifestyle. It was important to consider walkability and takeaway food availability together because to examine them separately risks unobserved confounding by the other. Future research could incorporate additional environmental measures, especially those likely to be correlated.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103405"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2024.103407
Marie Bolster , Julia Fricke , Thomas Reinhold , Lars Kuchinke , Christiane Ludwig-Körner , Franziska Schlensog-Schuster , Thomas Keil , Anne Berghöfer , Stephanie Roll
{"title":"The association between neighbourhood socioeconomic status and parental mental health in the first years after birth – Cross-sectional results from the SKKIPPI project","authors":"Marie Bolster , Julia Fricke , Thomas Reinhold , Lars Kuchinke , Christiane Ludwig-Körner , Franziska Schlensog-Schuster , Thomas Keil , Anne Berghöfer , Stephanie Roll","doi":"10.1016/j.healthplace.2024.103407","DOIUrl":"10.1016/j.healthplace.2024.103407","url":null,"abstract":"<div><h3>Background</h3><div>The urban environment can influence mental health. However, research on neighbourhood influences on mental health of parents with young children is sparse. This study aimed to analyse the association between neighbourhood socioeconomic status (SES) and mental health outcomes in urban parents in the first years after birth.</div></div><div><h3>Methods</h3><div>We included 4707 parents of young children who participated in the SKKIPPI cohort study in Berlin. Data on mental health outcomes (symptoms of depression, anxiety, or both, measured via PHQ- 4) and individual risk factors stemmed from an online questionnaire and were matched with neighbourhood level data from the Berlin Senate Department for Urban Development and Housing. Neighbourhood status (exposure) was categorized in 4 SES categories: high, medium, low, and very low. We use propensity scores to estimate the probability to live in each neighbourhood category to reduce the risk of bias due to neighbourhood self-selection. Binominal generalised linear mixed models with propensity score adjustment were used to estimate the association between neighbourhood SES and symptoms of depression, anxiety, or both.</div></div><div><h3>Results</h3><div>Overall, 9.3% of parents showed depressive, 10.3% anxiety, and 5.3% both symptoms. The occurrence of mental health problems was lowest in neighbourhoods with high SES and highest in neighbourhoods with low/very low SES. The association between neighbourhood SES and mental health outcomes seen in unadjusted regression models disappeared when models were adjusted for individual risk factors/neighbourhood self-selection using propensity scores.</div></div><div><h3>Conclusion</h3><div>We found no association between neighbourhood SES and mental health outcomes in parents in the first years after birth after adjusting for neighbourhood selection. Nevertheless, the unadjusted findings suggest that the occurrence of individual risk factors and mental health problems was highest in neighbourhoods with low/very low SES, which should be focus for social and preventive health measures.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103407"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2024.103393
Luy Dau , Paula Barros , Elizelle Juanee Cilliers , Bronwyn Hemsley , Michael Martin , Monica Lakhanpaul , Melody Smith
{"title":"Urban density and child health and wellbeing: A scoping review of the literature","authors":"Luy Dau , Paula Barros , Elizelle Juanee Cilliers , Bronwyn Hemsley , Michael Martin , Monica Lakhanpaul , Melody Smith","doi":"10.1016/j.healthplace.2024.103393","DOIUrl":"10.1016/j.healthplace.2024.103393","url":null,"abstract":"<div><div>This scoping review explores the relationship between urban density and child health and wellbeing, focusing on how urban density has been measured and its association with various child health outcomes. By analysing 53 studies spanning from 1972 to 2023, we identify significant variability in how urban density is defined and measured and mixed evidence regarding its relationship with different child health outcomes. We also highlight context-specific findings, which may be connected to a range of dynamic and interconnected local and socio-cultural factors. While most studies showed mixed or inconclusive results for physical health and mental health and wellbeing, some consistent findings were observed for positive associations between urban density and growth and nutritional status in studies from Asia and Africa, and for negative impacts on child development in studies from Europe and North America. The review highlights the need for improved reporting standards, consistent terminology, and context-specific approaches to better understand and address the complex interplay between urban density and child health. It underscores the importance of considering broader social determinants and the unique experiences of children within urban environments for improved policy, practice and placemaking, advocating for participatory research methods to capture children's perspectives on urban density.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103393"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2025.103416
Liang Mao
{"title":"Modeling time-varying spatial accessibility to healthcare: A system dynamic approach","authors":"Liang Mao","doi":"10.1016/j.healthplace.2025.103416","DOIUrl":"10.1016/j.healthplace.2025.103416","url":null,"abstract":"<div><div>Spatial accessibility to healthcare is essential for policymakers to identify health disparities and develop targeted interventions. Current modeling approaches poorly capture temporal dynamics of contributing factors, and few have represented dynamic interactions among these factors. Further, validating current models is hindered by data limitations and methodological challenges. To fill these gaps, I propose a new modeling approach that produces time-varying and empirically validated measures of healthcare accessibility. Specifically, I develop a system dynamic model to represent interplay between population demand and healthcare supply over time. The model simultaneously estimated people's potential accessibility to healthcare and their utilization over time and space, then validated these estimates with actual hospitalization data. To illustrate the model's practical use, a working prototype was constructed to estimate and validate healthcare accessibility by day and by ZIP code in Florida, USA, during a disease outbreak in 2022-23. The results indicate that system dynamic modeling offers a robust framework for monitoring healthcare accessibility fluctuations across regions and time periods, thereby guiding the development of timely and targeted interventions to reduce disparities.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103416"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2024.103411
Lingbo Liu , Lauren Cowan , Fahui Wang , Tracy Onega
{"title":"A multi-constraint Monte Carlo Simulation approach to downscaling cancer data","authors":"Lingbo Liu , Lauren Cowan , Fahui Wang , Tracy Onega","doi":"10.1016/j.healthplace.2024.103411","DOIUrl":"10.1016/j.healthplace.2024.103411","url":null,"abstract":"<div><div>This study employs an innovative multi-constraint Monte Carlo simulation method to estimate suppressed county-level cancer counts for population subgroups and extend the downscaling from county to ZIP Code Tabulation Areas (ZCTA) in the U.S. Given the known cancer counts at a higher geographic level and larger demographic groups at the same geographic level as constraints, this method uses the population structure as probability in the Monte Carlo simulation process to estimate suppressed data entries. It not only ensures consistency across various data levels but also accounts for demographic structure that drives varying cancer risks. The 2016–2020 cancer incidence data from the Utah Cancer Registry is used to validate our approach. The method yields results with high precision and consistency across the full urban-rural continuum, and significantly outperforms several machine-learning models such as Random Forest and Extreme Gradient Boosting.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103411"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health & PlacePub Date : 2025-01-01DOI: 10.1016/j.healthplace.2025.103417
Emily C. Dore
{"title":"Geographical variation in the long-arm of childhood","authors":"Emily C. Dore","doi":"10.1016/j.healthplace.2025.103417","DOIUrl":"10.1016/j.healthplace.2025.103417","url":null,"abstract":"<div><div>Scholars have documented the lasting impact of childhood socioeconomic status (SES) on health, but few studies have considered how state contexts in childhood shape health trajectories based on childhood SES across the life course. The current project uses data from the Panel Study of Income Dynamics, 2009–2021 (N = 18,227 person-year observations of adults aged 18–41) to build on these studies by 1) examining state variation in the relationship between childhood SES and adult self-rated health, and 2) assessing the contributions of childhood state-level economic context in moderating this relationship. Logistic regression models first confirmed the expected relationship between childhood SES and adult self-rated health that parallels other literature (OR = 1.79, 95% CI 1.46, 2.19). Of the 37 states included in the analysis, there was a statistically significant difference in reporting poor health between low and high-childhood SES groups in 14 states. The interaction between childhood SES and state-level income inequality (OR = .01, 95% CI -9.77, −.62), suggests that exposure to higher levels of income inequality in childhood was more harmful for the health of individuals from higher SES backgrounds. The interaction between childhood SES and unemployment rates (OR = 1.13, 95% CI 1.03, 1.24), suggests that exposure to higher unemployment rates in childhood was more harmful for the health of individuals from lower SES backgrounds. This study finds important state-variation in the relationship between childhood SES and adult health and identifies income inequality and unemployment rates as factors in these differences.</div></div>","PeriodicalId":49302,"journal":{"name":"Health & Place","volume":"91 ","pages":"Article 103417"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}