Socio-Economic Status and Age-Related Disability in a Biracial Community

This application is a continuation of an epidemiologic study that investigates the effect of
socio-economic disadvantage and neighborhood conditions on disability in older blacks and
whites. The proposed project takes place in the context of a population-based, longitudinal
study of persons aged 65 years and over who live in a geographically defined, urban,
biracial community area in Chicago. During the initial funding period, we have successfully
collected yearly disability outcome data, and detailed information on neighborhood
conditions using self-report instruments and a systematic neighborhood survey of study area.

The first overall goal of this continuation is to determine the relative contribution and
specific nature of the neighborhood conditions that are associated with disability in older
adults. The second overall goal is to determine the biological mechanisms through which
neighborhood conditions lead to increased disability, focusing specifically on hyperactivity
of the hypothalamus-pituitary-adrenal (HPA) axis, via salivary cortisol, and inflammatory
processes, via interleukin-6 (IL-6) and C-reactive protein (CRP), obtained from blood
samples. To accomplish these goals, we propose to continue yearly collection of disability
outcome data and obtain blood samples and salivary cortisol from over 7,000 participants.
These data will be integrated with a rich set of existing data on personal characteristics,
health conditions, and neighborhood factors to test of series of specific hypotheses related
to the overall goals.

Disability is a common and highly prevalent consequence of age-related chronic diseases, and
a critical indicator of overall health among older people. Prevention of disability is
essential to improve the lives of older people and reduce health care costs. The proposed
work will contribute to a better understanding of the specific neighborhood conditions that
are associated with increased disability, laying the foundation for more effective policies
to prevent disability in future generations of older adults.

inclusion criteria: adults aged 65 years and over exclusion criteria: none