Irina B. Grafova

Neighborhoods and disability in later life

This paper uses the US Health and Retirement Study to explore linkages between neighborhood conditions and stages of the disablement process among adults aged 55 years and older in the United States. We consider multiple dimensions of the neighborhood including the built environment as well as social and economic conditions. In doing so, we use factor analysis to reduce indicators into eight neighborhood scales, which we incorporate into two-level logistic regression models along with controls for individual-level factors. We find evidence that economic conditions and the built environment, but not social conditions, matter. Neighborhood economic advantage is associated with a reduced risk of lower body limitations for both men and women. We also find for men that neighborhood economic disadvantage is linked to increased chances of reporting personal care limitations, particularly for those aged 55-64 years, and that high connectivity of the built environment is associated with reduced risk of limitations in instrumental activities. Our findings highlight the distinctive benefits of neighborhood economic advantage early in the disablement process. In addition, findings underscore the need for attention in the design and evaluation of disability-prevention efforts to the benefits that accrue from more physically connected communities and to the potential harm that may arise in later life from living in economically disadvantaged areas.

Neighborhoods and Obesity in Later Life

OBJECTIVES We examined the influence of neighborhood environment on the weight status of adults 55 years and older. METHODS We conducted a 2-level logistic regression analysis of data from the 2002 wave of the Health and Retirement Study. We included 8 neighborhood scales: economic advantage, economic disadvantage, air pollution, crime and segregation, street connectivity, density, immigrant concentration, and residential stability. RESULTS When we controlled for individual- and family-level confounders, living in a neighborhood with a high level of economic advantage was associated with a lower likelihood of being obese for both men (odds ratio [OR] = 0.86; 95% confidence interval [CI] = 0.80, 0.94) and women (OR = 0.83; 95% CI = 0.77, 0.89). Men living in areas with a high concentration of immigrants and women living in areas of high residential stability were more likely to be obese. Women living in areas of high street connectivity were less likely to be overweight or obese. CONCLUSIONS The mechanisms by which neighborhood environment and weight status are linked in later life differ by gender, with economic and social environment aspects being important for men and built environment aspects being salient for women.

The effect of friends on adolescent body weight

Using the first wave of the National Longitudinal Study of Adolescent Health (Add Health) survey, this paper examines the influence of peers on adolescent weight. A peer group is defined as a close circle of friends that are identified by a respondent adolescent. After controlling for school fixed effects and for a number of individual, demographic and family characteristics, we find that a higher Body Mass Index (BMI) of close friends is correlated to a higher BMI of the respondent adolescent. However, after instrumental variable analysis is performed, the effect remains significant only among women. We also found that adolescents are more responsive to the body weight of their same gender friends.

Overweight children: assessing the contribution of the built environment

OBJECTIVE To examine the relationship between the built environment and overweight status in children. METHODS Analyses were based on 2482 children aged 5-18 and their primary care givers who participated in the second wave of the Child Development Supplement (CDS-II) of the Panel Study of Income Dynamics (PSID). CDS-II is a nationally representative survey that was administered in October 2002-May 2003. A number of built environment characteristics were examined: population density, alpha index of connectivity, urban design, pedestrian fatality from motor vehicle crashes, restaurant density, and grocery store and convenience store densities. Also, interviewers observations on neighborhood physical disorder, such as the condition and upkeep of the buildings and street surface on the block were analyzed. RESULTS Living in a neighborhood with higher convenience store density (OR=1.3, p<0.05) and living in a neighborhood built after 1969 (OR=1.9, p<0.01) is associated with a higher probability of being overweight for children and adolescents. Living in the neighborhood where no physical disorder (OR=0.5, p<0.01) is observed is associated with a decreased likelihood of being overweight. CONCLUSIONS The results of this study emphasize a particular importance of the built environment of the neighborhood for weight status of children and adolescents.

Neighborhoods and chronic disease onset in later life.

OBJECTIVES To strengthen existing evidence on the role of neighborhoods in chronic disease onset in later life, we investigated associations between multiple neighborhood features and 2-year onset of 6 common conditions using a national sample of older adults. METHODS Neighborhood features for adults aged 55 years or older in the 2002 Health and Retirement Study were measured by use of previously validated scales reflecting the built, social, and economic environment. Two-level random-intercept logistic models predicting the onset of heart problems, hypertension, stroke, diabetes, cancer, and arthritis by 2004 were estimated. RESULTS In adjusted models, living in more economically disadvantaged areas predicted the onset of heart problems for women (odds ratio [OR] = 1.20; P < .05). Living in more highly segregated, higher-crime areas was associated with greater chances of developing cancer for men (OR = 1.31; P < .05) and women (OR = 1.25; P < .05). CONCLUSIONS The neighborhood economic environment is associated with heart disease onset for women, and neighborhood-level social stressors are associated with cancer onset for men and women. The social and biological mechanisms that underlie these associations require further investigation.

The Wage Effects of Personal Smoking History

This study explores determinants of the wage penalty borne by smokers. The authors reconstruct individual smoking histories by pooling PSID (Panel Study of Income Dynamics) data for 1986–2001. They find no wage gap between former smokers and those who had never smoked, but statistically significant wage gaps between smokers who would continue smoking and three other groups: those who would later quit smoking, those who had quit smoking already, and those who never smoked. The wage penalty for smoking, observed in the 1986 cross-section, is largely driven by those who would continue smoking over the years 1986–2001. These results suggest that the smoker/nonsmoker wage differential observed at any given time may be driven by a non-causal explanation rather than by smoking per se. For example, persistent smokers may be characterized by myopia that leads to reduced investment in health capital and firm-specific or other human capital.

The Difference-in-Difference Method: Assessing the Selection Bias in the Effects of Neighborhood Environment on Health

This paper uses the difference-in-difference estimation approach to explore the self-selection bias in estimating the effect of neighborhood economic environment on self-assessed health among older adults. The results indicate that there is evidence of downward bias in the conventional estimates of the effect of neighborhood economic disadvantage on self-reported health, representing a lower bound of the true effect.