Cumulative Exposure to Neighborhood Context: Consequences for Health Transitions Over the Adult Life Course

Philippa Clarke, Jeffrey Morenoff, Michelle Debbink, Ezra Golberstein, Michael R. Elliott, Paula M. Lantz

Research output: Contribution to journalArticlepeer-review

90 Scopus citations


Over the last two decades, research has assessed the relationship between neighborhood socioeconomic factors and individual health. However, existing research is based almost exclusively on cross-sectional data, ignoring the complexity in health transitions that may be shaped by long-term residential exposures. We address these limitations by specifying distinct health transitions over multiple waves of a 15-year study of American adults. We focus on transitions between a hierarchy of health states, (free from health problems, onset of health problems, and death), not just gradients in a single health indicator over time, and use a cumulative measure of exposure to neighborhoods over adulthood. We find that cumulative exposure to neighborhood disadvantage has significant effects on functional decline and mortality. Research ignoring a persons' history of exposure to residential contexts over the life course runs the risk of underestimating the role of neighborhood disadvantage on health.

Original languageEnglish (US)
Pages (from-to)115-142
Number of pages28
JournalResearch on Aging
Issue number1
StatePublished - Jan 2014

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was supported by National Institute on Aging grant R01AG018418.


  • functional health
  • life course
  • mortality
  • neighborhood effects
  • panel data
  • socioeconomic status


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