Dr. Eva DuGoff
April 12, 2018

According to a new study by a research team including SPH Assistant Professor Eva DuGoff (HLSA) published in the Journal of the American Geriatrics Society, living in a socio-economically disadvantaged neighborhood can have a negative influence on older adults’ health and well-being. 

Older adults who live in disadvantaged neighborhoods report having poorer health and have more difficulty getting around and performing their daily tasks. They also tend to have more chronic illnesses and higher rates of death than do older adults who live in less disadvantaged neighborhoods.

Multiple mechanisms affect the relationship between disadvantaged neighborhoods and health. Research has found that disadvantaged neighborhoods have lower levels of social support for older adults and their caregivers, and these neighborhoods also tend to have fewer physical resources like health care, retail and recreational facilities. 

Considering how important social and other resources are for older adults, living in disadvantaged neighborhoods may pose additional challenges for them to maintain their health and levels of function.

To learn more about the impact neighborhoods can have on older adults’ health, researchers used the 2013 Medicare Health Outcome Survey (HOS) survey, a telephone and mail survey of older adults enrolled in Medicare Advantage (MA) health plans. Some 17.6 million people—31 percent of the Medicare population—are enrolled in MA plans. Information about 187,434 older adults was included in the study. 

“Previously, our knowledge about Medicare recipients and their ability to function and perform their daily tasks had been focused on fee-for-service Medicare beneficiaries,” Dr. DuGoff says. “This study expands on that knowledge, because MA plans serve one-third of Medicare beneficiaries.”

The researchers concluded that neighborhood disadvantage is an important predictor of functional limitations among MA beneficiaries, particularly for those with multiple chronic conditions. MA beneficiaries who have multiple chronic conditions and who live in the most disadvantaged neighborhoods—compared to those living in less disadvantaged neighborhoods—are 12 percent more likely to report a functional limitation. 

Increasing resources in disadvantaged neighborhoods to support health programs for older adults could improve their health outcomes, the researchers say.

“Linking Neighborhood Context and Health in Community-Dwelling Older Adults in the Medicare Advantage Program” was published in the Journal of the American Geriatrics Society. The study authors are Daniel Jung, BS; Amy Kind, MD, PhD; Stephanie Robert, MSW, PhD; William Buckingham, PhD; Eva DuGoff, PhD, MPP.

Related Links

Linking Neighborhood Context and Health in Community‐Dwelling Older Adults in the Medicare Advantage Program

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Eva DuGoff