Is your neighborhood friendly?: Neighborhood social contexts and age-related health outcomes

Abstract

This dissertation investigates the role of perceived neighborhood social cohesion in shaping key age-related health outcomes – psychological resilience, cognitive function, and inflammation – across three empirical studies using data from the Health and Retirement Study (HRS). Study 1, using multi-level modeling, examined the effects of neighborhood social capital (quasi-objective measure) and perceived neighborhood social cohesion (subjective measure) on psychological resilience. Results indicated that both predictors were positively associated with psychological resilience. A significant interaction also emerged: older adults residing in neighborhoods with greater social capital were likely to have greater psychological resilience when they perceived their neighborhood as socially cohesive. Study 2 identified distinct pain trajectories and their relationship with cognitive function and examined the role of perceived neighborhood social cohesion on the relationship using growth mixture modeling. The results revealed that older adults who experienced moderate–decreasing pain or severe-decreasing pain reported a significant lower level of cognitive function compared to those who had minimal–increasing pain after controlling for sociodemographic variables. Additionally, with health-related covariates, only older adults who experienced moderate–decreasing pain showed a significantly lower level of cognitive function compared to those with minimal-increasing pain. However, the moderating effect of perceived neighborhood social cohesion was not significant. Study 3 explored the potential mediating role of sleep disturbance and the moderating role of perceived neighborhood social cohesion in the relationship between lifetime discrimination and systemic inflammation (i.e., C-reactive protein; CRP), among non-Hispanic African Americans. The analyses found no significant direct effects of lifetime discrimination on sleep disturbance or CRP. With these null results, study 3 offered insights into methodological and conceptual considerations for future research investigating the relationship between discrimination and inflammation. While the protective effects of neighborhood cohesion vary by context and health outcomes, these three studies contribute to the field of aging research by illuminating the multifaceted role of perceived neighborhood social cohesion in older adults' health. The findings underscore the need for further investigation into accessible social resources within residential areas to support healthy aging.