Living in a disadvantaged neighborhood associated with trauma and lower active life expectancy for older adults and persons with disabilities.

This article was initially published 9/2/21 in RACmonitor, and appears with explicit permission

Significant data already proves increased disease morbidity and mortality for populations who reside in specific ZIP codes. The “ZIP Code Effect” has been associated with variations in neighborhood life expectancy by as much as 33 years; research has also shown ACEs  as major factors to drive health outcomes in these neighborhoods. Research out of Yale University took a new direction, exploring older adults and persons living with disabilities. The data continues to demonstrate a mandate to hone in on society’s most vulnerable populations in specific areas, especially neighborhoods with the lowest socioeconomic figures.

Researchers recruited roughly 750 adults from South-Central Connecticut in 1988, all at least 70 years of age at the start of the study. The team interviewed the patients over 22 years, collecting patient-reported outcomes specific to mobility and functionality through monthly interviews. Disability in four essential activities of daily living (bathing, dressing, walking, and transferring) was assessed via monthly scores using the Area Deprivation Index, a census-based socioeconomic measure with 17 education, employment, housing quality, and poverty indicators, obtained through linkages with the 2000 Neighborhood Atlas.

The study’s outcomes won’t surprise this group; active life expectancy was consistently lower for participants from disadvantaged neighborhoods, versus those who lived in ZIP codes and wealthier regions, with more access to quality healthcare and other factors. These differences persisted and remained statistically significant, even after adjustment for individual-level race and ethnicity, education, income, and other prognostic factors. Those living in low-income or otherwise disadvantaged neighborhoods become disabled roughly two years prior to individuals living in more affluent areas. For example, a 70-year-old living a more affluent ZIP code was able to maintain their independence for an average of 14.2 years, versus a 70-year-old living in a less affluent ZIP code; the latter was only able to maintain independence for 12.3 more years.

Data was consistent with that of other recent studies, which have shown the synergy between trauma, racial health disparities and the Healthy People 2030 social determinants of health (SDoH) domains of Neighborhood and Built Environment, as well as Social Cohesion and Community Context. At the end of the day, living in a disadvantaged neighborhood was associated with lower active life expectancy and greater percentage of projected remaining life with disability.

We can and must do better for society’s most vulnerable individuals. Links to the survey research will appear in my upcoming story this week for RACmonitor. If you’re unsure which communities served by your organization have the most disadvantaged populations, the Neighborhood Atlas has an interactive state map providing the details.

This week’s Monitor Mondays survey asked listeners how familiar they are with their organization’s most and least advantaged populations served; the answers appear here.