Assessing neighbourhood effects on the health of older people using ELSA Iain Lang Epidemiology & Public Health Group, Peninsula Medical School

Two of ELSA’s strongest components: health/functioning and micro-economics Neighbourhood context is associated with poor health in later life – is this simply a “compositional effect”? Linkage of ELSA data to quintiles of the Index of Multiple Deprivation (IMD 2004) available from NatCen on request

Outcomes assessed Mobility: change in gaitspeed from Wave to Wave 2; incident self- reported walking problems Cognition: standardized cognitive function score Obesity and waist circumference Frailty: frailty index score

Potential confounders (differ by analysis) Age, sex, rural-urban, population density, duration of residence, level of education, number of comorbidities, smoking status, BMI, level of physical activity, visual problems, hearing loss, eyesight, depressive symptoms, alcohol consumption,

Standardized cognition score by level of neighbourhood deprivation, unadjusted

Standardized cognition score by level of neighbourhood deprivation, fully adjusted, ages 70+

Rate of incident mobility problems after 2- year follow-up by level of neighbourhood deprivation, unadjusted, ages 70+

Odds ratios of having incident mobility problems after 2 years, by level of neighbourhood deprivation (adjusted) Self-reportedMeasured

Odds ratios of obesity and high waist circumference by level of neighborhood education deprivation

Frailty index score by IMD and SES

What’s going on here? Do differences by level of neighbourhood deprivation represent uncontrolled confounding by individual- or household- level differences?

What’s going on here? Do differences by level of neighbourhood deprivation represent uncontrolled confounding by individual- or household- level differences? What are the mechanisms by which neighbourhood deprivation influences individual health and well-being in older people?

What’s going on here? Do differences by level of neighbourhood deprivation represent uncontrolled confounding by individual- or household- level differences? What are the mechanisms by which neighbourhood deprivation influences individual health and well-being in older people? What are the effects of subjective perceptions about neighbourhoods?

I.A.Lang, D.J.Llewellyn, R.B.Wallace, K.M.Langa, D.Melzer Neighborhood deprivation and incident mobility disability among older adults. Age and Ageing, 37(4): I.A.Lang, D.J.Llewellyn, K.M.Langa, F.A.Huppert, R.B.Wallace, D.Melzer Neighborhood deprivation, individual socioeconomic status, and cognitive function in older people: analyses from the English Longitudinal Study of Ageing. Journal of the American Geriatrics Society, 56(2): I.A.Lang, D.J.Llewellyn, D.Melzer. Low levels of neighborhood educational attainment are associated with obesity in adults. Under review. I.A.Lang, R.E.Hubbard, M.K. Andrew, D.J.Llewellyn, D.Melzer, K.Rockwood. Neighborhood Deprivation, Individual Socioeconomic Status, and Frailty in Older Adults. Under review.