Biological embedding of neighborhood disadvantage and collective efficacy: Influences on chronic illness via accelerated cardiometabolic age

Abstract

The present study extends prior research on the link between neighborhood disadvantage and chronic illness by testing an integrated model in which neighborhood characteristics exert effects on health conditions through accelerated cardiometabolic aging. Hypotheses were tested using a sample of 408 African Americans from the Family and Community Health Study. Using four waves of data spanning young adulthood (ages 18-29), we first found durable effects of neighborhood disadvantage on accelerated cardiometabolic aging and chronic illness. Then, we used marginal structural modeling to adjust for potential neighborhood selection effects. As expected, accelerated cardiometabolic aging was the biopsychosocial mechanism that mediated much of the association between neighborhood disadvantage and chronic illness. This finding provides additional support for the view that neighborhood disadvantage can influence morbidity and mortality by creating social contexts that becomes biologically embedded. Perceived neighborhood collective efficacy served to buffer the relationship between neighborhood disadvantage and biological aging, identifying neighborhood-level resilience factor. Overall, our results indicate that neighborhood context serves as a fundamental cause of weathering and accelerated biological aging. Residing in a disadvantaged neighborhood increases biological wear and tear that ultimately leads to onset of chronic illness, but access to perceived collective efficacy buffers the impact of these neighborhood effects. From an intervention standpoint, identifying such an integrated model may help inform future health-promoting interventions.

The impact of neighborhood disadvantage on health-related quality of life among African American and White cancer survivors

“…Consistent with the extant literature on neighborhood disadvantage and chronic illness outcomes (25-28), neighborhood disadvantage was associated with QOL outcomes among our sample of African American and White cancer survivors. Specifically, cancer survivors, regardless of race, who resided in a more disadvantaged neighborhood (i.e., higher prevalence of poor households, of mother-only households, of non-owner occupied units, and of adults without a college degree) reported significantly lower PHQOL scores than those residing in more advantaged neighborhoods.…”

Systemic racism, chronic health inequities, andCOVID‐19: A syndemic in the making?

“…The simultaneous attention to disease interaction and disease concentration keeps in the foreground that physiological dysregulation and possible interactions between COVID‐19 and cardiometabolic disease are socially patterned. Indeed, the same physiological systems that are the focus of interactions among hypertension, diabetes, and COVID‐19 are also involved in the pathways that link neighborhood disadvantage, racial discrimination, and poverty to racial inequities in hypertension and diabetes (Cobb, Parker, & Thorpe, 2020; Dolezsar, McGrath, Herzig, & Miller, 2014; Dusendang et al, 2019; Lei, Beach, & Simons, 2018; Panza et al, 2019; Simons et al, 2018). It is plausible, therefore, that the COVID‐19 pandemic in the U.S. involves both kinds of interactions put forward by syndemic theory: (a) biological interactions between overlapping diseases (ie, diabetes, hypertension, and COVID‐19) and (b) biosocial ones between noxious social conditions and the biological processes involved in progression of SARS‐CoV‐2 infection to COVID‐19 risk.…”

Cultural development and psychopathology

“…Parental support was related with greater cortisol awakening responses, whereas familism values were not associated with diurnal cortisol patterns. Lei, Beach, and Simons (2018) tested the degree to which neighborhood characteristics shape accelerated cardiometabolic aging with a longitudinal sample of 408 African Americans assessed from ages 18 to 29. Accelerated aging mediated the link between neighborhood disadvantage and chronic illness, even after adjusting for neighborhood selection effects.…”