RCMI Pilot Project

January 1, 2020 – December 31, 2020

 

PI:  Amy Thierry, Ph.D.

 

Title:  Examining the Role of Neighborhood Context and Biobehavioral Risk Factors for Physical Disability in Midlife and Older Adults with Chronic Conditions

 

 

A dearth of literature examines how neighborhood conditions, particularly disorder and social cohesion, contribute to the disproportionate burden of physical disability experienced by racial/ethnic midlife and older adults in the US, especially in adults diagnosed with chronic conditions. Moreover, little is known about how underlying biobehavioral processes may be implicated in the complex relationship between neighborhoods and health across race/ethnicity. This includes understanding how specific chronic conditions as well as behavioral risk factors (e.g., smoking, alcohol use, and physical activity) may be associated with physical disability development.

Specific Aims:

Aim 1. To estimate prevalence of physical disability measured as functional limitations, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) across race/ethnicity and chronic disease (e.g., cancer, cardiovascular disease, and diabetes).

Aim 2. To examine the relationship between perceptions of neighborhood characteristics (e.g., disorder and social cohesion) and number of physical disabilities and identify if these relationships differ by race/ethnicity and chronic condition diagnosis.

Aim.3. To examine if interactions of neighborhood characteristics and behavioral risks (e.g., smoking status. alcohol use, and physical activity) are associated with number of physical disabilities across race/ethnicity and by chronic condition diagnosis.

Methodological Approach:

We will analyze population data from approximately 5,000 non-Hispanic white, non-Hispanic black, and Mexican American midlife and older adults included in the 2014 wave of the Health and Retirement Study (HRS), a nationally representative study of US adults >50 years of age. Average number of physical disabilities and proportion disabled will be estimated for each racial/ethnic group and by chronic condition (Aim 1). Linear regression models stratified by race/ethnicity will test the association between perceived neighborhood disorder and social cohesion and number of physical disabilities (Aim 2). Lastly, interaction terms using neighborhood characteristics and behavioral risk factors will be included in linear regression models predicting number of physical disabilities across race/ethnicity and chronic conditions (Aim 3).

Implications:

This research will increase understanding of racial/ethnic disparities in physical disability within the broader context of neighborhood characteristics in midlife and older adults with one or more chronic conditions. Thus, this research aligns with NIH goals for conducting innovative population research on aging disparities that can inform future interventions and policy changes. Furthermore, this research contributes to Xavier's mission of promoting a more just and humane society by expanding current knowledge about the health status of midlife and older racial/ethnic minority adults in the US. In particular, this study will apply a health equity lens to examine the social and behavioral conditions that shape physical disability - a clinically meaningful measure of health with implications on the wellbeing of older adults, their families, communities, and the nation at large.