Longitudinal analysis of the impact of neighborhood context on allostatic load in older puerto ricans

A body of research documents that neighborhood context may influence individuals' health and mortality. Most of these studies are constrained by cross-sectional designs that limit testing for causal direction and examination of potential paths through which the association operates. Repeated exposure to socio-environmental stressors and the ongoing adaptive efforts of the organism to maintain stability in response to stress can affect health. Puerto Rican populations experience high racial residential segregation that may expose them to conditions that influence health. We used data from the Boston Puerto Rican Health Study, with 1,504 Puerto Rican participants (age 45-75) at baseline (T1) and 1,164 at the 2-year follow-up (T2). Using two-level bivariate hierarchical linear models, with random intercept for the census block-group (neighborhood) level, we tested the impact of neighborhood context at T1 on Allostatic Load (AL). Census-based neighborhood variables include racial/ethnic composition, neighborhood poverty and housing tenure.

We model the 2- year change score in AL as the dependent variable, and baseline neighborhood context as predictors. Results suggest that Puerto Ricans living in block groups with higher baseline % Latino exhibited higher AL at T2 (B=1.10, p=0.03). Moreover, a higher % of households with income below Boston's median income and a higher % of renters in the neighborhood also showed a positive impact on AL (B=0.42, p=0.2 and B=0.3, p=0.2 respectively). Understanding how neighborhood contexts influence health is imperative to comprehend health disparities and their causes among Latinos, and leveraging longitudinal designs is necessary to strengthen the neighborhood-health literature.