Background
Multilevel frameworks suggest neighborhood circumstances influence biology; however, this relationship is not well-studied. Telomere length(TL) shortening has been associated with individual-level and neighborhood-level exposures and disease, and may provide insights into underlying biologic mechanisms linking neighborhood with biology. To support neighborhood-biology investigations, we sought to determine the independent effect of neighborhood exposures on TL using standard multilevel linear regression models and quantile regression--a nonlinear, social science method applicable to testing the biologic hypothesis that extremes of the TL distribution are related to poor outcomes.
Methods
In a multicenter, cross-sectional study, blood TL was measured in 1,488 individuals from 127 census tracts in three U.S. regions using terminal restriction fragment assays. Multilevel linear and quantile regression models, were adjusted for individual-level race, education, perceived stress, depression. Neighborhood exposures included population density, urban/residential crowding, residential stability/mobility, socioeconomic status(SES).
Results
TL was not associated with any neighborhood variable using linear models, but quantile regression revealed inverse associations between population density and urban crowding at the lower tails of the TL distribution (5th(population density-p-value=0.03;urban crowding-p-value=0.002), 50th(both p-values<0.001), 75th percentiles(both p-values<0.001)). TL was related to residential stability at the upper tail (95th percentile-p-value=0.006).
Conclusion
Findings support the use of nonlinear statistical methods in TL research and suggest that neighborhood exposures can result in biological effects.
Impact
TL may serve as an underlying example of a biologic mechanism that can link neighborhood with biology, thus supporting multilevel investigations in future studies.