Racial differences in the longitudinal association between perceived neighborhood disorder and allostatic load

Background and Objectives: Neighborhood disorder represents an environmental stressor that contributes to physiological wear and tear on the body, known as allostatic load. This study examines racial differences in the longitudinal associations between perceived neighborhood disorder and allostatic load among middle-aged and older adults. Research Design and Methods: Utilizing a nationally representative sample from 6 waves of the Health and Retirement Study (2006–2016, N = 14,769), we constructed allostatic load using 8 biomarkers indicative of physiological dysregulation. Perceived neighborhood disorder was assessed with a 4-item scale. Using a machine learning-based generalized boosted regression tree model to generate inverse probability weights, we performed inverse probability weighted mixed-effects models to assess racial differences in the longitudinal association between perceived neighborhood disorder and allostatic load, adjusting for covariates and residential selection bias. Results: Black respondents exhibited a 26% higher baseline allostatic load compared to their White counterparts. Longitudinal analyses further revealed a significantly steeper trajectory of allostatic load among Black respondents (B = 0.132, 95% confidence interval [CI]: 0.069–0.195). Perceived neighborhood disorder was positively associated with allostatic load only among Black respondents (B = 0.047, 95% CI: 0.001–0.092), with no significant association observed in White respondents. Discussion and Implications: This study highlights perceived neighborhood disorder as a critical risk factor for elevated allostatic load among Black older adults. These results underscore the importance of considering the racially stratified nature of neighborhoods in understanding place-based health disparities.