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Neighborhood environment and the disablement process in elderly Hispanics

Kushang V. Patel, MPH, Dept. of Preventive Medicine and Community Health, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1153, 409/772-8658, kvpatel@utmb.edu, Karl Eschbach, PhD, Sealy Center on Aging, University of Texas Medical Branch, 301 University Blvd., 3.222 Jennie Sealy Rte 0460, Galveston, TX 77555-0460, and Kyriakos S. Markides, PhD, Dept. of Preventive Medicine and Community Health/ Division of Sociomedical Sciences, University of Texas Medical Branch, 700 Harborside Dr, Ewing Hall 1.128, Galveston, TX 77555-1153.

Background: Recent data indicate elderly Hispanics experience higher prevalence of disability than older non-Hispanic Whites. The process through which this disparity develops is poorly understood. However, a growing public health literature linking neighborhood characteristics to health suggests that neighborhood social environment may play an important role in the disablement process. This study investigates the longitudinal effects of neighborhood socioeconomic level and ethnic composition on disablement in elderly Mexican Americans. Methods: Longitudinal data on 3,050 older Mexican Americans residing in the southwestern United States during 1993-94 were merged with 1990 US Census data. All subjects were matched to one of 210 census tracts (neighborhoods). Multilevel regression models were used to examine cross-sectional and longitudinal relationships between neighborhood-level variables and individual-level disablement outcomes. Results: After adjusting for individual-level characteristics (age, sex, and socioeconomic position), older Mexican Americans living in economically disadvantaged neighborhoods were more likely to have higher levels of morbidity, poorer cognitive function, and poorer lower body function than subjects living in more advantaged neighborhoods. Although no association was observed between neighborhood economic level and prevalent disability, the 2-year risk for incident disability was significantly higher among subjects living in economically impoverished neighborhoods. Interestingly, neighborhood ethnic composition had a countervailing effect whereby subjects living in more ethnically homogenous Mexican American neighborhoods had significantly better health and functional outcomes than subjects residing in ethnically diverse neighborhoods. Conclusion: Community social environment deserves further investigation as a moderator of the disablement process in older Hispanics.

Learning Objectives: At the conclusion of the presentation, session attendees will be able to

Keywords: Disability, Aging

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Exploring the Social Environment of Older Adults

The 132nd Annual Meeting (November 6-10, 2004) of APHA