Neighborhood Children Research Articles

Health Disparities in Exercise Performance in Patients with Repaired Tetralogy of Fallot.

Black patients with tetralogy of Fallot (TOF) have higher mortality than White patients. Health disparities related to other patient-important outcomes, such as exercise performance, have not been studied in this population. We aimed to determine if there are racial disparities related to exercise performance in patients with TOF and to investigate possible mediators of those disparities. We conducted a retrospective single center study of patients aged 8-25years with repaired TOF who completed maximal cardiorespiratory exercise tests between 2007 and 2020. The primary outcome was percent predicted oxygen consumption at peak exercise. We used linear regression to determine if race was associated with exercise performance. We used mediation analysis to investigate insurance coverage and neighborhood Child Opportunity Index as possible mediators of this relationship. The study cohort included 163 patients with TOF (136 non-Hispanic/Latinx White and 27 non-Hispanic/Latinx Black). In multivariable analysis, Black patients had a lower percent predicted peak oxygen consumption than White patients by 6.71 percentage points (95% CI -12.71, -0.70; p = 0.029). Mediation analysis revealed that the indirect effect of race through insurance coverage accounted for 34.1% of the decrease in exercise performance. Child Opportunity Index was not a statistically significant mediator. Black patients with TOF had worse exercise performance than White patients. Differences in insurance coverage accounted for a significant portion of this difference. Exercise performance is an important outcome for patients with TOF, and further investigation is needed to better understand this disparity and develop interventions to address it.

Gender Differences in the Association Between Childhood Neighborhood Quality and Depressive Symptoms Trajectory in Middle-Aged and Elderly Chinese: A Seven-Year Longitudinal Study.

This study aimed to examine the role of childhood neighborhood quality on trajectories of depressive symptoms throughout later life based on a nationally representative sample, and to explore the role of gender in the association. Linear mixed-effects model analysis was performed to investigate a longitudinal association of childhood neighborhood quality with depressive symptoms. A total of 7,016 participants aged 45 and above were included in this study. Depressive symptoms progression was significantly faster (β [95% confidence interval, CI]: 0.13 [0.01, 0.25]; P = .027) in the low childhood neighborhood quality when compared with the high childhood neighborhood quality. The quality of childhood neighborhood was significantly associated with a change in depressive symptoms over time in females (β [95% CI]: 0.19 [0.02, 0.36]; P = .029) but not in males (β [95% CI]: 0.09 [-0.06, 0.25]; P = .224). Targeted interventions should be developed to prevent depressive symptoms for those vulnerable groups.

Childhood Neighborhood Disadvantage and Cognitive Function among Veterans Recovering from Mild Traumatic Brain Injury

Abstract Objective Identifying risk factors and interventions for chronic symptoms following mild traumatic brain injury (TBI) is an important area of research for Veterans. Growing up in a disadvantaged neighborhood is associated with poorer health outcomes. We examined the relationship between childhood neighborhood disadvantage and cognitive outcomes among symptomatic Veterans with history of mild TBI. Method 58 Participants completed neuropsychological tests (CVLT-3, TMT A&B, COWA, Category Test), NSI, and PCL-5. The Neighborhood Atlas was used to derive disadvantage scores using childhood addresses. Global deficit scores were calculated as described by Heaton (2004). Results Neighborhood disadvantage was significantly correlated with CVLT-3 Total Learning (r = −0.26, p = 0.046), but not the overall global deficit or deficit performance across CVLT-3 Delayed Recall, TMT-A, TMT-B, COWA, and Category Test. There was a significant difference in neighborhood disadvantage between participants scoring in the deficit and normal ranges on CVLT-3 Total Learning (p = 0.046). There were no other differences in neighborhood disadvantage across other neuropsychological tests. There was a significant difference in PTSD symptoms between participants scoring within the deficit and normal ranges on the COWA (p = 0.002). There were no other significant group differences in neuropsychiatric symptoms or PTSD symptom severity. Conclusions Among Veterans in this sample, neighborhood disadvantage was not associated with cognitive function or cognitive deficits. Although neighborhood disadvantage is an important psychosocial risk factor for poor outcomes in the civilian literature, these results suggest that it may not be an important contributing factor in recovery from mild TBI for military Veterans.

Association Between Neighborhood Context and Psychotropic Polypharmacy Use Among High-Need Children.

The authors explored whether neighborhood context is associated with psychotropic polypharmacy and psychotherapy among a cohort of children with high needs for psychiatric and general medical care. Electronic health record data from a large health care system were used in a cross-sectional design to examine psychotropic polypharmacy and psychotherapy in 2015-2019 among children ages 2-17 years (N=4,017) with geocoded addresses. Inclusion criteria were a diagnosis of a mental health condition, an intellectual and developmental disability, or a complex medical condition and one or more clinical encounters annually over the study period. Polypharmacy was defined as two or more psychotropic drug class prescriptions concurrently for ≥60 days. Psychotherapy was defined as receipt of any psychotherapy or adaptive behavior treatment. Neighborhood context (health, environment, education, and wealth) was measured with the Child Opportunity Index. Multilevel generalized linear mixed models with random intercept for census tracts were used to assess the associations between individual and neighborhood characteristics and psychotropic polypharmacy and psychotherapy. Moderate (vs. low) child opportunity was associated with higher odds of polypharmacy (adjusted OR [AOR]=1.79, 95% CI=1.19-2.67). High (vs. low) child opportunity was associated with higher odds of psychotherapy (AOR=2.15, 95% CI=1.43-3.21). Black (vs. White) race (AOR=0.51, 95% CI=0.37-0.71) and Hispanic ethnicity (AOR=0.44, 95% CI=0.26-0.73) were associated with lower odds of polypharmacy. Among high-need children, neighborhood Child Opportunity Index, race, and ethnicity were significantly associated with treatment outcomes in analyses adjusted for clinical factors. The findings underscore concerns about structural disparities and systemic racism and raise questions about access.

A model of nursing intervention on the psychological needs of a group of neighborhood children in a shelter place in Surabaya

The fulfillment of the psychological needs of neglected children in shelters is important. However, only the physical need has been fulfilled, resulting in a feeling of dissatisfaction and hampers a positive attitude towards the social environment. Therefore, this study aimed to present a significant nursing intervention model to meet the psychological needs of neglected children. The model integrates behavioral (Lawrence Green), Caring (Jean Watson), and psychogenic needs theory (Murray) to explain the influence of predisposing, enabling, and supporting factors on behavior. This study adopted a cross-sectional design and observational analytic method with a population of 240 neglected children in Surabaya city shelters. The cluster sampling rule of thumb was used in SEM to select 110 (5x22 observe variables) respondents. The result showed that the unique aspects of the group nursing intervention model fulfilled the psychological needs of adolescents in shelters. Furthermore, interpersonal human caring behavior was influenced by predisposing factors and care values with a coefficient value of 0.203. Supporting factors and environmental caring had a coefficient of 0.220 while driving was 0.332. In conclusion, this study showed that the group nursing intervention model fulfilled the psychological needs of adolescents in shelters by integrating the theories of goal attainment, caring (Jean Watson), and psychosocial (Murray). These theories increased adolescent parenting actions, thereby enhancing self-confidence within shelters.

Neighborhood Child Opportunity and Preterm Birth Rates by Race and Ethnicity

In the US, infants born to non-Hispanic Black birthing parents are 50% more likely to be born preterm than those born to non-Hispanic White birthing parents, and individual-level factors do not fully account for this inequity. Neighborhood context, rooted in historic patterns of structural racism, may facilitate understanding patterns of inequity in preterm birth. To estimate the association between neighborhood opportunity level, measured by the Child Opportunity Index (COI), and preterm birth among infants in Massachusetts. In this cross-sectional, population-based study, Massachusetts birth certificates from 3 large metropolitan areas (Boston, Springfield, and Worcester) were linked to US Census tract-level data from the COI, and log binomial regression models and generalized estimating equations were fit to examine associations of different levels of opportunity with preterm birth. Singleton infants born in Massachusetts between February 1, 2011, and December 31, 2015, were included. Analyses were originally conducted in 2019 and updated in 2024. Level of child opportunity (measured by the COI) at the US Census tract level. Race and ethnicity were ascertained from the birth certificate, as reported by the birthing parent. Live birth before 37 completed weeks' gestation. The analytic dataset included 267 553 infants, of whom 18.9% were born to Hispanic, 10.1% to non-Hispanic Asian or Pacific Islander, 10.1% to non-Hispanic Black, and 61.0% to non-Hispanic White birthing parents. More than half of infants born to non-Hispanic Black and Hispanic birthing parents were born into very low opportunity neighborhoods, and in crude models, this was associated with greater prevalence of preterm birth relative to very high opportunity neighborhoods (prevalence ratio, 1.44; 95% CI, 1.37-1.52). After adjustment for covariates, infants born into very low opportunity neighborhoods still had a greater prevalence of preterm birth (prevalence ratio, 1.16; 95% CI, 1.10-1.23). In this cross-sectional study of neighborhood opportunity and preterm birth, elevated risk associated with exposure to a very low opportunity neighborhood, coupled with the disproportionate exposure by race and ethnicity, points to a modifiable factor that may contribute to racial and ethnic inequities in preterm birth. Future research should investigate interventions that seek to address neighborhood opportunity.

Early Adversity and Socioeconomic Factors in Pediatric Multiple Sclerosis: A Case-Control Study.

Psychosocial adversity and stress, known to predispose adults to neurodegenerative and inflammatory immune disorders, are widespread among children who experience socioeconomic disadvantage, and the associated neurotoxicity and proinflammatory profile may predispose these children to multiple sclerosis (MS). We sought to determine associations of socioeconomic disadvantage and psychosocial adversity with odds of pediatric-onset MS (POMS), age at POMS onset, and POMS disease activity. This case-control study used data collected across 17 sites in the United States by the Environmental and Genetic Risk Factors for Pediatric Multiple Sclerosis Study. Cases (n = 381) were youth aged 3-21 years diagnosed with POMS or a clinically isolated demyelinating syndrome indicating high risk of MS. Frequency-matched controls (n = 611) aged 3-21 years were recruited from the same institutions. Prenatal and postnatal adversity and postnatal socioeconomic factors were assessed using retrospective questionnaires and zip code data. The primary outcome was MS diagnosis. Secondary outcomes were age at onset, relapse rate, and Expanded Disability Status Scale (EDSS). Predictors were maternal education, maternal prenatal stress events, child separation from caregivers during infancy and childhood, parental death during childhood, and childhood neighborhood disadvantage. MS cases (64% female, mean age 15.4 years, SD 2.8) were demographically similar to controls (60% female, mean age 14.9 years, SD 3.9). Cases were less likely to have a mother with a bachelor's degree or higher (OR 0.42, 95% CI 0.22-0.80, p = 0.009) and were more likely to experience childhood neighborhood disadvantage (OR 1.04 for each additional point on the neighborhood socioeconomic disadvantage score, 95% CI 1.00-1.07; p = 0.025). There were no associations of the socioeconomic variables with age at onset, relapse rate, or EDSS, or of prenatal or postnatal adverse events with risk of POMS, age at onset, relapse rate, or EDSS. Low socioeconomic status at the neighborhood level may increase the risk of POMS while high parental education may be protective against POMS. Although we did not find associations of other evaluated prenatal or postnatal adversities with POMS, future research should explore such associations further by assessing a broader range of stressful childhood experiences.

Impact of Parental Time Investment on Child Development among Dual Income Family

This cross-sectional study investigates how early childhood development is impacted by parental time commitment in the Horizon Hill dual-income family community. This study employs quantitative method approach to examine how changes in parental engagement dynamics affect children's behavior, mental health, and cognitive functioning both before and after the intervention. The results demonstrate that families have a great involvement rate, with 10 out of 11 demonstrating a strong dedication to enhancing their children's developmental experiences through the program's seamless integration into their daily routines. The results also show that advances in children's cognitive, social, emotional, and behavioral dimensions positively correspond with higher parental investment. These findings highlight how important parental participation is in helping Horizon Hill neighborhood children have great early experiences. This study has ramifications that go beyond improving child well-being and encouraging good parenting techniques through community-based interventions. By comprehending how parental time investment affects child development, policymakers and practitioners can create focused initiatives that enable parents to create caring environments that support their kids' development and success. This study adds to our understanding of the dynamics of parent-child relationships and emphasizes how important it is to spend quality time raising children to promote positive developmental outcomes.

Is the availability and quality of local early childhood education and care services associated with young children's mental health at school entry?

PurposeThis study investigated the relationship between geographic availability (and quality) of local early childhood education and care services and children's early mental health outcomes for all children entering their first year of full-time school in Melbourne, Australia. MethodsWe capitalise on a unique population linked dataset, the Australian Early Development Census – Built Environment, which combines geospatial measures of children's neighbourhoods with demographic information and child mental health outcomes for all school entrants in Australia's 21 most populous cities and towns. Objective early childhood education and care service location and quality exposures were developed for each study child based on home addresses. Four geographic availability exposures (counts within 3 km) were examined for cross-sectional associations with child mental health outcomes (externalising and internalising difficulties, competence). We estimated associations using multilevel logistic regression (Markov Chain Monte Carlo estimation) adjusting for child demographics and stratifying by urbanicity. ResultsChildren with higher counts of high-quality preschool services within 3 km of home had lower odds of difficulties and higher odds of competence. Overall, exposures were most consistently associated with children's competence. Across all outcomes, the most consistent patterning was observed for children living in the inner city and middle ring. Results varied depending on whether service quality was accounted for in measures of availability. Geographic availability of early childhood services showed patterning by neighbourhood disadvantage and by maternal education. ConclusionWe found some evidence that geographic availability of high-quality preschools was associated with better child mental health outcomes, but results varied by urbanicity. While future research is required to unpack these differences, these findings indicate the importance of accounting for both geographic availability and service quality simultaneously in future research, policy and practice.

Neighborhood environment, socioeconomic conditions, and intergenerational mobility

Intergenerational mobility (IM) has recently generated significant attention. However, the mechanisms of IM, including the neighborhood effects, are still not well understood. This research aims to advance the research on IM by emphasizing the role of neighborhood environments and their mediating effects in the United States. Our results suggest that childhood neighborhood conditions significantly affect IM, and IM is determined by childhood physical and socioeconomic status (SES) or conditions and outmigration. Specifically, we find that natural and built environments affect IM indirectly through neighborhood SES, and, therefore, the effect of SES has been overestimated. Moreover, there are complex pathways linking neighborhood SES to IM. A dense, mixed-use, and walkable neighborhood may show lower IM because such neighborhoods usually have higher concentrations of poor people and single parents. We also find that outmigration is a pathway to IM. Desirable childhood neighborhood environments and high outmigration returns lead to higher IM in rural areas than in urban areas, and also higher IM in the West North Central region than in the East South Central and South Atlantic regions, although these regions have similarly low SES. Our study highlights the significant effects of the neighborhood environment on IM.

Tracing participants for longitudinal environmental health research using social networking sites: a pilot study

Aim: Longitudinal cohort study designs are considered the gold standard for investigating associations between environmental exposures and human health yet they are characterized by limitations including participant attrition, and the resource implications associated with cohort recruitment and follow-up. Attrition compromises the integrity of research by threatening both the internal and external validity of empirical results, weakening the accuracy of statistical inferences and the generalizability of findings. This pilot study aimed to trace participants from a historical cohort study, the Hamilton Child Cohort Study (HCC) (n = 3,202), (1976–1986, 2003–2008) which was originally designed to examine the relative contribution of indoor and outdoor exposure to air pollution on respiratory health. Methods: Original participants were traced through social networking sites (SNS) by leveraging personal identifying data (name, age, sex, educational affiliation, and geographical locations) from the HCC entered into SNS search engines. Results: Of the original cohort (n = 3,166), 21% (n = 665) were identified as having social media presence (SMP) on a single social media platform, with 15% (n = 479) found on Facebook, 6% (n = 185) on LinkedIn, < 1% (n = 9) on Instagram, and n = 1 participant on Twitter. However, 68% (n = 2,168) of the cohort were associated with multiple SNS with the same features (matching names, ages, and locations), making conclusive identification challenging. The remaining 11% (n = 334) of the cohort had no SMP (NSMP). Statistical differences in sample characteristics of each cohort were analyzed using the Pearson chi-square test. Significant differences between the SMP and NSMP cohorts were found in relation to sex (p < 0.001), and childhood neighborhood of residence (p < 0.05). Conclusions: This study underscores social media’s potential for tracing participants in longitudinal studies while advising a multi-faceted approach to overcome inherent limitations and biases. A full-scale study is necessary to determine whether utilizing SNS to trace participants for longitudinal research is an effective tool for re-engaging research participants lost to attrition.

The effects of two types of neighborhood factors on trajectory of internalizing and externalizing symptoms from early childhood to adolescence.

Although a robust body of previous empirical studies investigated the long-term trend of child behavior problems, limited research discussed the influences of various types of neighborhood factors on such trajectory (e.g., neighborhood structural characteristics and collective efficacy). Using a nationally representative longitudinal dataset the Fragile Families and Child Wellbeing Study (FFCWS), with six waves from 1998 to 2017, this study captures the longitudinal effects of two types of early childhood neighborhood factors on the co-development of internalizing and externalizing symptoms. Data was collected at the focal child's age 3, age 5, age 9, age 15 (N = 2,385), and the parallel-process growth curve models were applied. Results suggest that the trajectories of both internalization and externalizing symptoms showed U-shape and bidirectional relationships among internalizing and externalizing problems. The long-term effects of neighborhood social cohesion and economic disadvantages were significantly associated with children's internalizing and externalizing symptoms. The implication of this study was further discussed.

A Pivotal Time and Place: University Place Attachment, Childhood Neighborhood Affordances, and Internalizing Symptoms in Emerging Adulthood

People-place dynamics matter for well-being and for 69% of emerging adults in the US, the university is a pivotal place at a pivotal time. Research suggests that low childhood neighborhood affordances contribute to internalizing symptoms, but we know less about the impact of the university context. This study asked: how does university place attachment impact internalizing symptoms beyond the effects of childhood neighborhood affordances? Two-hundred and seventy-five university students self-reported on perceived childhood neighborhood affordances, university attachment, and current internalizing symptoms. Higher university attachment coincided with higher perceived neighborhood affordances and lower depression and social anxiety symptoms while controlling for demographic factors and parent-child relationship quality. Further, there was an indirect effect of neighborhood affordances via university attachment on social anxiety, but not depressive symptoms. Findings suggest that university place attachment contributes meaningfully to internalizing symptoms in emerging adulthood and that childhood neighborhood affordances may impact attachment to novel life-spaces.

Neighborhood child opportunity is associated with hospital length of stay following pediatric burn injury

IntroductionPediatric burns are associated with socioeconomic disadvantage and lead to significant morbidity. The Child Opportunity Index (COI) is a well-validated measure of neighborhood characteristics associated with healthy child development. We sought to evaluate the relationship between COI and outcomes of burn injuries in children. MethodsWe performed a single-institution retrospective review of pediatric (<16 years) burn admissions between 2015 and 2019. Based on United States residential zip codes, patients were stratified into national COI quintiles. We performed a multivariate Poisson regression analysis to determine the association between COI and increased length of stay. Results2095 pediatric burn admissions occurred over the study period. Most children admitted were from very low (n = 644, 33.2 %) and low (n = 566, 29.2 %) COI neighborhoods. The proportion of non-Hispanic Black patients was significantly higher in neighborhoods with very low (44.5 %) compared to others (low:28.8 % vs. moderate:11.9 % vs. high:10.5 % vs. very high:4.3 %) (p < 0.01). Hospital length of stay was significantly longer in patients from very low COI neighborhoods (3.6 ± 4.1 vs. 3.2 ± 4.9 vs. 3.3 ± 4.8 vs. 2.8 ± 3.5 vs. 3.2 ± 8.1) (p = 0.02). On multivariate regression analysis, living in very high COI neighborhoods was associated with significantly decreased hospital length of stay (IRR: 0.51; 95 % CI: 0.45–0.56). ConclusionChildren from neighborhoods with significant socioeconomic disadvantage, as measured by the Child Opportunity Index, had a significantly higher incidence of burn injuries resulting in hospital admissions and longer hospital length of stay. Public health interventions focused on neighborhood-level drivers of childhood development are needed to decrease the incidence and reduce hospital costs in pediatric burns. Type of studyRetrospective study Level of evidenceLevel III

Perceived childhood neighborhood safety and sleep health during childhood and adulthood among a cohort of African American women

ObjectiveTo investigate associations between perceived childhood neighborhood safety and sleep over the life course. MethodsAmong a cohort of 1693 Black/African American women aged 23–35 years at enrollment (2010–2012), participants recalled neighborhood safety (safe vs. unsafe) when they were 5, 10, and 15 years old. Participants’ mothers/caregivers and participants reported sleep-related health behaviors at age 5. We used ordinal logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sleep-related health behaviors (i.e., rarely/never or sometimes vs. mostly/always going to bed by 8:00 p.m., bed in a quiet room, bed in a dimly lit or unlit room), separately. Adulthood sleep duration and insomnia symptoms were reported at enrollment and over three follow-up periods. We applied generalized estimating equations to log binomial regression models to estimate relative risks (RR) for adulthood sleep characteristics. Results and conclusionsFour percent of participants reported an unsafe neighborhood at age 5 years, only, and 12% reported an unsafe neighborhood at all ages. Participants in perceived unsafe vs. safe neighborhoods at age 5 had higher odds of poor sleep-related health behaviors (e.g., rarely/never or sometimes going to bed in a quiet room: OR = 1.73 [1.27–2.35]). Participants in perceived unsafe vs. safe neighborhoods throughout childhood had higher risk of short sleep (RR = 1.10 [1.02–1.18]) and insomnia symptoms (RR = 1.07 [1.00–1.15]) during adulthood after adjustment for life course socioeconomic characteristics and adulthood health behaviors and characteristics. Perceived unsafe childhood neighborhood was associated with poorer sleep over the life course and may serve as an early intervention target.

Childhood neighbourhood quality, peer relationships, and trajectory of depressive symptoms among middle-aged and older Chinese adults.

This study aimed to examine childhood neighbourhood quality, peer relationships, and trajectories of depressive symptoms among middle-aged and older Chinese adults. The data came from the longitudinal dataset from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018). Depressive symptoms were measured repeatedly using the ten-item Centre for Epidemiologic Studies Depression Scale (CES-D-10). Latent growth modelling was used to capture the trajectory of depressive symptoms by childhood neighbourhood quality, and peer relationships. The mean level of depressive symptoms increased gradually in the follow-up period. Poorer childhood neighbourhood quality, and peer relationships were significantly associated with higher levels of depression in later life (β = 0.18 and β = 0.28 for aged 45-59, p < 0.001; β = 0.16 and β = 0.33 for aged 60 and over, p < 0.001) at baseline and a faster increase in depressive symptoms with age for childhood neighbourhood quality (β = 0.03, p < 0.01 for aged 45-59; β = 0.05, p < 0.01 for aged 60 and over). For males and females, poorer childhood neighbourhood quality, and peer relationships predicted higher levels of depression at baseline (β = 0.17 and β = 0.36 for males, p < 0.001; β = 0.16 and β = 0.27 for females, p < 0.001), and only neighbourhood quality was associated with a higher rate of change in depression during follow-up (β = 0.03, and β = 0.04, p < 0.05, respectively). Poorer childhood neighbourhood quality was associated with the slope of change in depressive symptoms. Efforts towards improving childhood living conditions may help to prevent the detrimental health effects of such early life disadvantages.

Markers of chronic disease risk in term low birthweight Indian children aged 8-14 years.

Low birth weight (LBW) is a public health problem in India with consequences in the short and long term. It increases the risk of obesity and its related comorbidities including type 2 diabetes and cardiovascular disease (CVD) in later life. This study aimed to assess the risk markers of chronic disease in term born low birthweight Indian children aged 8-14 years. This was a cross-sectional follow-up of LBW children from DIViDS (Delhi Infant Vitamin D Supplementation) cohort and involved assessment of their anthropometric measurements, body composition, levels of adipokines and biomarkers of chronic diseases. Neighbourhood children born normal birth weight (NBW) (>2.5 kg) were enrolled for comparison. The study included 667 LBW and 87 NBW children. Height-for-age, body mass index for-age (BMIZ), fat-free mass index, and waist circumference of LBW children were lower than those of NBW children. LBW children could jump farther. LBW children who were now overweight had higher leptin, triglyceride and VLDL and lower HDL, compared to NBW children in the same BMIZ category. Currently underweight LBW children had higher adiponectin and lower leptin levels than the reference group. There were no differences between LBW and NBW children in visfatin, fasting glucose and insulin, hemoglobin A1c, triglyceride, low density lipoprotein or C-reactive protein. At 8-14 years few children were overweight and there were few differences in some risk markers of chronic disease between LBW and NBW children. Overweight, which was associated with some increased risk markers, may increase with age, thus timely counselling and monitoring of these LBW children will be important to mitigate these risks.

Longitudinal Associations between Childhood Neighborhood Disadvantage and Young Adult Income

Introduction: This study examines the relationship between neighborhood disadvantage experienced in childhood and income level in young adulthood, with further assessment of whether that relationship is moderated by the duration of or age at exposure. Methods: Relationships between three types of neighborhood disadvantage (i.e., cohesion, quality, safety) at three developmental stages (i.e., childhood, early adolescence, adolescence) and income at age 25 (±1 year) were assessed among employed young adults using multivariable fixed effects models stratified by gender in a retrospective cohort of 660 U.S. youths drawn from a nationally representative panel study. Results: Findings demonstrated that childhood exposure to unsafe neighborhoods is negatively associated with income, but neighborhood cohesion and quality showed no effect. Further, the length of exposure to unsafe neighborhoods has a negative association with income among females (though not among males), but only for those residing in the most dangerous neighborhoods for the longest durations. Finally, the age of exposure provided statistically equivalent effects, indicating that there was no evidence that exposure timing mattered. Conclusion: These results suggest that a multi-faceted view of neighborhood disadvantage may be helpful in understanding its potential influence on adult economic achievement and raises questions about how these contexts are differentially experienced across genders.

CAN YOU HEAR ME? IMPLICATIONS OF HEARING LOSS FOR SOCIAL TIES AMONG OLDER ADULTS

Abstract Hearing loss is a leading source of disability among older adults; over 65% of those aged 71 and older have hearing loss. Hearing loss may be associated with reduced relationship quality due to greater communication challenges, conflict, and avoidance of social interactions. This study examined links between hearing loss and social ties among older people. Participants included 11,161 respondents from the 2016 and 2018 waves of the Health and Retirement Study (ages 50+) who completed a hearing test and reported on their social ties (contact, quality), social activities (e.g., charity work), and loneliness. Multilevel models controlling for age, gender, and education revealed that having hearing loss was associated with having lower positive quality and higher negative quality relationships with spouse and friends, higher negative relationship quality with children, having fewer close friends, meeting up less with friends, greater loneliness, doing less charity work, and less attendance at social and community events. Older age was associated with more detrimental outcomes. Older aged individuals with hearing loss met up with friends less often, talked on the phone less with friends, did fewer activities with grandchildren/extended children and neighborhood children, did less charity work, and attended fewer social events compared to younger individuals with hearing loss. Overall, older adults with hearing loss are at high risk for relationship problems and social isolation; especially as they grow older. Hearing loss and social ties are important targets for future interventions for older adults with hearing loss as they may be particularly vulnerable.

Residential Structural Racism and Prevalence of Chronic Health Conditions

Studies elucidating determinants of residential neighborhood-level health inequities are needed. To quantify associations of structural racism indicators with neighborhood prevalence of chronic kidney disease (CKD), diabetes, and hypertension. This cross-sectional study used public data (2012-2018) and deidentified electronic health records (2017-2018) to describe the burden of structural racism and the prevalence of CKD, diabetes, and hypertension in 150 residential neighborhoods in Durham County, North Carolina, from US census block groups and quantified their associations using bayesian models accounting for spatial correlations and residents' age. Data were analyzed from January 2021 to May 2023. Global (neighborhood percentage of White residents, economic-racial segregation, and area deprivation) and discrete (neighborhood child care centers, bus stops, tree cover, reported violent crime, impervious areas, evictions, election participation, income, poverty, education, unemployment, health insurance coverage, and police shootings) indicators of structural racism. Outcomes of interest were neighborhood prevalence of CKD, diabetes, and hypertension. A total of 150 neighborhoods with a median (IQR) of 1708 (1109-2489) residents; median (IQR) of 2% (0%-6%) Asian residents, 30% (16%-56%) Black residents, 10% (4%-20%) Hispanic or Latino residents, 0% (0%-1%) Indigenous residents, and 44% (18%-70%) White residents; and median (IQR) residential income of $54 531 ($37 729.25-$78 895.25) were included in analyses. In models evaluating global indicators, greater burden of structural racism was associated with greater prevalence of CKD, diabetes, and hypertension (eg, per 1-SD decrease in neighborhood White population percentage: CKD prevalence ratio [PR], 1.27; 95% highest density interval [HDI], 1.18-1.35; diabetes PR, 1.43; 95% HDI, 1.37-1.52; hypertension PR, 1.19; 95% HDI, 1.14-1.25). Similarly in models evaluating discrete indicators, greater burden of structural racism was associated with greater neighborhood prevalence of CKD, diabetes, and hypertension (eg, per 1-SD increase in reported violent crime: CKD PR, 1.15; 95% HDI, 1.07-1.23; diabetes PR, 1.20; 95% HDI, 1.13-1.28; hypertension PR, 1.08; 95% HDI, 1.02-1.14). This cross-sectional study found several global and discrete structural racism indicators associated with increased prevalence of health conditions in residential neighborhoods. Although inferences from this cross-sectional and ecological study warrant caution, they may help guide the development of future community health interventions.