Neighborhood disadvantage, individual-level socioeconomic position and physical function : A cross-sectional multilevel analysis
Loh, Venurs H. Y., Rachele, Jerome N., Brown, Wendy J., Washington, Simon and Turrell, Gavin. (2016) Neighborhood disadvantage, individual-level socioeconomic position and physical function : A cross-sectional multilevel analysis. Preventive Medicine. 89, pp. 112-120. https://doi.org/10.1016/j.ypmed.2016.05.007
|Authors||Loh, Venurs H. Y., Rachele, Jerome N., Brown, Wendy J., Washington, Simon and Turrell, Gavin|
Introduction: Understanding associations between physical function and neighborhood disadvantage may provide insights into which interventions might best contribute to reducing socioeconomic inequalities in health. This study examines associations between neighborhood-disadvantage, individual-level socioeconomic position (SEP) and physical function from a multilevel perspective.
Methods: Data were obtained from the HABITAT multilevel longitudinal (2007-13) study of middle-aged adults, using data from the fourth wave (2013). This investigation included 6,004 residents (age 46-71 years) of 535 neighborhoods in Brisbane, Australia. Physical function was measured using the PF-10 (0 – 100), with higher scores indicating better function. The data were analyzed using multilevel linear regression and was extended to test for cross-level interactions by including interaction terms for different combinations of SEP (education, occupation, household income) and neighborhood disadvantage on physical function.
Results: Residents of the most disadvantaged neighborhoods had significantly lower function (men: β -11.36 95% CI -13.74, -8.99; women: β -11.41 95% CI -13.60, -9.22). These associations remained after adjustment for individual-level SEP. Individuals with no post-school education, those permanently unable to work, and members of the lowest household income had significantly poorer physical function. Cross-level interactions suggested that the relationship between household income and physical function is different across levels of neighborhood disadvantage for men; and for education and occupation for women.
Conclusion: Living in a disadvantaged neighborhood was negatively associated with physical function after adjustment for individual-level SEP. These results may assist in the development of policy-relevant targeted interventions to delay the rate of physical function decline at a community-level.
|Keywords||physical function; neighborhood; multilevel modeling; socioeconomic position|
|Journal citation||89, pp. 112-120|
|Digital Object Identifier (DOI)||https://doi.org/10.1016/j.ypmed.2016.05.007|
|Open access||Published as green open access|
|Research or scholarly||Research|
|Research Group||Institute for Health and Ageing|
|Author's accepted manuscript|
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