American Journal of Epidemiology Advance Access originally published online on January 18, 2006
American Journal of Epidemiology 2006 163(5):450-458; doi:10.1093/aje/kwj054
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Original Contribution |
Neighborhood Conditions and Risk of Incident Lower-Body Functional Limitations among Middle-aged African Americans
1 Department of Medicine and Pediatrics, Washington University School of Medicine, St. Louis, MO
2 North Florida/South Georgia Veterans Health System, Gainesville, FL
3 College of Public Health and Health Professions, University of Florida, Gainesville, FL
4 Department of Health Management and Policy, College of Public Health, The University of Iowa, Iowa City, IA
5 Department of Psychiatry, School of Medicine, Saint Louis University, St. Louis, MO
6 Division of Biostatistics, Washington University School of Medicine, St. Louis, MO
7 Indiana University Center for Aging Research, Regenstrief Institute for Health Care, Indiana University School of Medicine, Indianapolis, IN
Correspondence to Dr. Mario Schootman, Washington University School of Medicine, Campus Box 8504, 4444 Forest Park Boulevard, St. Louis, MO 63110 (e-mail: mschootm{at}im.wustl.edu).
The authors investigated the association between observed neighborhood conditions and lower-body functional limitations (LBFLs) using data from 563 subjects of the African-American Health Study. This population-based cohort received in-home evaluations. Five items involving LBFL were obtained at baseline (2000–2001) and 3 years later. Subjects were considered to have LBFL if they reported difficulty on at least two of the five tasks. The external appearance of the block the respondent lived on was rated during sample enumeration by use of five items (rated excellent, good, fair, or poor). Of 563 subjects with 0–1 LBFL at baseline, 15% and 14% lived in neighborhoods with 4–5 and 2–3 fair/poor conditions, respectively. Logistic regression adjusting for propensity scores showed that persons who lived in neighborhoods with 4–5 versus 0–1 fair/poor condition were 3.07 times (95% confidence interval: 1.58, 5.94) more likely to develop two or more LBFLs. The odds ratio was 2.24 (95% confidence interval: 1.07, 4.70) when living in neighborhoods with 2–3 conditions versus 0–1 fair/poor condition. Odds ratios for individual neighborhood characteristics varied from 3.45 (fair/poor street conditions) to 2.01 (fair/poor noise level). Sensitivity analyses showed the robustness of the findings. Poor neighborhood conditions appear to be an independent contributor to the risk of incident LBFLs in middle-aged African Americans.
African Americans; aging; health status indicators; questionnaires; residence characteristics; social environment
Abbreviations: CI, confidence interval; LBFL, lower-body functional limitation; OR, odds ratio
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