Academic journal article Annual Review of Gerontology & Geriatrics

Neighborhoods and Health in Later Life: The Intersection of Biology and Community

Academic journal article Annual Review of Gerontology & Geriatrics

Neighborhoods and Health in Later Life: The Intersection of Biology and Community

Article excerpt


Increasing urbanization coupled with population aging suggests that the neighborhood context in which people grow old may shape their health, longevity, and well-being. In this chapter, we examine the neighborhood-health relationship within the context of age and aging. We summarize the literature on neighborhoods and health, lay out a set of theories that inform the study of neighborhood structural and social process factors, and suggest two promising new directions in research on neighborhoods, aging, and health: (1) study of neighborhoods and households as nested contexts and (2) the examination of biomarkers in large-scale social surveys that include a geographic component. These two pursuits illustrate the additional potential of neighborhood-based research in gerontology and geriatric research.


The neighborhood context of health outcomes is perhaps most compelling in the study of those deemed vulnerable. The burgeoning literature on neighborhoods and health finds its surest footing in research focused on childhood well-being or older adult health (Brooks-Gunn, McCormick, Klebanov, & McCarton, 1998; Cagney, Browning, & Wen, 2005; Culhane & Elo, 2005; Nelson et al., 2009; Pienta & Ghimire, 2009). From a practical standpoint, these age groups are often more closely tethered to the neighborhood than those in midlife. From a theoretical standpoint, these stages in the life course are interesting because they are often marked by social, physiological, and cognitive change; we theorize that the social environment shapes the extent to which these age groups are able to activate opportunities and, more generally, thrive. The desired opportunities of course differ, but both groups are supported by the structural and social process factors that create an environment conducive to health and well-being.

In this chapter, we focus on the unique pull of the neighborhood-health relationship for older adults. From time to time, we will draw insight from literature that focuses on other stages of the life course, but our purpose here is to characterize the neighborhood context of older adult health outcomes. We organize this chapter around three key questions:

(1) Why might we expect the neighborhood-based social and physical environment to have an impact on older adult health?

(2) What are the approaches to defining and characterizing the neighborhood social and physical environment?

(3) What new directions in neighborhood-health research might be instructive, and how might they better inform our understanding of the mechanisms linking neighborhood to health?

Although we emphasize the role of neighborhood physical and social surroundings, we acknowledge the critical interplay of personal and family characteristics. Elsewhere in this volume scholars discuss spirituality, personality, family context, and socioeconomic status in their relationship to older adult health (see Chapters 9 through 13). We direct you to these chapters for an indepth treatment of these individual- and family-based influences. Our approach is not meant to downplay these influences but rather to draw out the context in which they operate.

We first turn to a review of neighborhood research in aging. We then step back to consider the theoretical underpinnings of this work, highlighting recent innovations and implications for measurement and methods. Finally, we provide two examples of new directions in neighborhood-based research. The first is the study of households, their relationship to neighborhood, and their promise for better characterizing the microenvironments we create as we age. The second is the use of biomarkers in large-scale social survey efforts, with the potential for linking biological, social, and geographic data to better assess context effects. We draw on these two examples with the goal of refining, if you will, both sides of the neighborhood-health equation - by expanding neighborhood research to include other contexts in which older adults are embedded, and by extending health status assessment to consider the use of biological indicators. …

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