Abstract
The importance of neighbourhood on individual health is widely documented. Less is known about the relative role of objective and subjective reports of neighbourhood conditions, how their effect on health changes as people age, and whether they moderate each other's impact on health. This study uses the English Longitudinal Study of Ageing (ELSA) to determine whether older adults report worse self-rated health as they age, and whether this differs between objective and subjective measures of neighbourhood. ELSA data contain 53,988 person-years across six waves collected biannually between 2002 and 03 and 2012and 13. Objective neighbourhood conditions are measured by the 2004 Index of Multiple Deprivation, and subjective neighbourhood conditions are captured by a summative neighbourhood dissatisfaction score. We find both objective and subjective neighbourhood composite scores independently predict poor health. There is no change over time in the probability of reporting poor health by baseline objective or subjective neighbourhood scores, suggesting neighbourhood effects do not compound as older adults age. There is no moderating effect of area dissatisfaction on the relationship between neighbourhood deprivation and health. The findings provide little support for causal neighbourhood effects operating in later life and indicate different causal pathways through which objective and subjective neighbourhood deprivation impact on health.
Highlights
A body of research suggests that a person’s health is affected by their individual characteristics as well as the residential environment in which they live (Ross et al, 2004; Tunstall, 2005; Yen et al, 2009)
Subjective ratings of the neighbourhood were associated with poor health at baseline; the predicted probability of poor health at mean age at the 75th percentile on the neighbourhood dissatisfaction distribution was 28% compared with 18% at the 25th percentile
This study showed an association between neighbourhood deprivation, neighbourhood dissatisfaction, and poor health in older adults
Summary
A body of research suggests that a person’s health is affected by their individual characteristics as well as the residential environment in which they live (Ross et al, 2004; Tunstall, 2005; Yen et al, 2009). Research has explored the link between neighbourhoods and health by taking into account the effect of either one or both objective (e.g. median income, unemployment rate, indices of multiple deprivation) and subjective (e.g. perceived neighbourhood quality, perceived cohesion, perceived safety, level of area dissatisfaction) characteristics on health outcomes (Weden et al, 2008). Considering both objective and subjective assessment of neighbourhood simultaneously are rare, and comparing their moderating effect on each other and how independently they affect health over time is rarer. This is a common limitation in the literature, which may lead to misestimating neighbourhood effects
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