The objective of this research is to understand the ways in which neighborhoods influence trajectories of physical and cognitive functioning and health of older men and women. Although much is known about the impact of social conditions and behaviors on the health and well-being of the elderly, less is understood about the residential environments which help to shape those conditions and behaviors. We test a model in which specific characteristics of neighborhoods or communities in which an older person lives can either enable the maintenance of functioning and independent living and serve to promote successful aging or may prove to be deleterious for health and functioning. This project is based on longitudinal data from the New Haven and Duke EPESE (Established Populations for the Epidemiologic Study of the Elderly) a cohort studies. The New Haven EPESE is a study of 2812 men and women 65 and older living in New Haven in 1982 and under continuous surveillance through 1994. The Duke EPESE is a study of 4,162 men and women living in the Piedmont, 5 county region of North Carolina, interviewed in 1986 and followed through 1996. We propose to merge data from these cohorts with ecological-level data from multiple sources including the census, government documents and historical information from the New Haven Regional Data Cooperative.
The specific aims of the study are: A) to refine an innovative conceptual model and set of measures of neighborhood characteristics. Our proposed model is 1) multidimensional spanning social and economic conditions to service-related and physical characteristics and is 2) germane to the study of the elderly. B. to examine the influence of neighborhood conditions on five primary health outcomes using multilevel modeling incorporating both ecological and individual level variables. The five outcomes are: 1) physical functioning, 2) cognitive functioning, 3) mortality, 4) self-rated health and 5) nursing home admissions. C) to identify behavioral (e.g. alcohol and tobacco consumption physical activity) and psychosocial (e.g. social networks, fear of crime, social engagement) pathways through which neighborhood characteristics affect health and functioning. D) to identify particular subgroups of older men and women who may be particularly vulnerable to the effects of neighborhood conditions. We hypothesize that frail and economically disadvantaged older men and women may be at particularly high risk.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
1R01AG018369-01A1
Application #
6332169
Study Section
Social Sciences, Nursing, Epidemiology and Methods 4 (SNEM)
Program Officer
Patmios, Georgeanne E
Project Start
2001-09-01
Project End
2004-08-31
Budget Start
2001-09-01
Budget End
2002-08-31
Support Year
1
Fiscal Year
2001
Total Cost
$389,255
Indirect Cost
Name
Harvard University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
City
Boston
State
MA
Country
United States
Zip Code
02115
Hybels, Celia F; Blazer, Dan G; Pieper, Carl F et al. (2006) Sociodemographic characteristics of the neighborhood and depressive symptoms in older adults: using multilevel modeling in geriatric psychiatry. Am J Geriatr Psychiatry 14:498-506
Avendano, Mauricio; Kawachi, Ichiro; Van Lenthe, Frank et al. (2006) Socioeconomic status and stroke incidence in the US elderly: the role of risk factors in the EPESE study. Stroke 37:1368-73
Subramanian, S V; Kubzansky, Laura; Berkman, Lisa et al. (2006) Neighborhood effects on the self-rated health of elders: uncovering the relative importance of structural and service-related neighborhood environments. J Gerontol B Psychol Sci Soc Sci 61:S153-60
Mendes de Leon, Carlos F; Bang, Woojeong; Bienias, Julia L et al. (2005) Changes in disability before and after myocardial infarction in older adults. Arch Intern Med 165:763-8
Kubzansky, Laura D; Subramanian, S V; Kawachi, Ichiro et al. (2005) Neighborhood contextual influences on depressive symptoms in the elderly. Am J Epidemiol 162:253-60