The Inequality of Aging in Place

The Inequality of Aging in Place
Jennifer Ailshire, Catherine García
Generations - Journal of the American Society on Aging
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Research shows that most people prefer to age in place—remaining at home, near family, and in their community as they get older. But not all places are equal, and harmful neighborhood conditions can lead to poorer health outcomes and reduced life expectancy.  Who bears the biggest burden from unequal neighborhood conditions?

Relying on data from the 2010 Health and Retirement Study and a scan of relevant academic literature, researchers examine how neighborhood poverty, disorder, social cohesion, and air pollution affect health outcomes for older adults of different incomes, races, and ethnicities. The evidence suggests that low-income older adults and older adults of color are more likely to live in neighborhoods with economic, social, and physical conditions that are detrimental to their health.

Key findings

  • Residents of economically disadvantaged neighborhoods—regardless of their own income level—are more likely to suffer from chronic diseases, mobility issues, cognitive impairment, and accelerated biological aging than those living in more economically prosperous neighborhoods.
  • At every level of income, Hispanic and Black older adults are more than twice as likely to live in high-poverty neighborhoods than white older adults—with some income levels showing much larger disparities.
  • Among adults with low incomes, 66 percent of older Blacks and 60 percent of older Hispanics reside in high-poverty neighborhoods compared with just 20 percent of older whites. Meanwhile, the share of upper-income older Blacks (32 percent) and Hispanics (24 percent) living in a high-poverty neighborhood is higher than the share of low-income older whites (22 percent) residing in such places.
  • Neighborhood disorder, from vacant buildings to safety concerns, can cause psychological distress and reduce rates of physical activity among older adults. Older adults with higher incomes generally perceive less disorder in their neighborhoods, but more Hispanic and Black older adults see signs of disorder in their neighborhoods than white adults, regardless of their income.
  • Strong connections and relationships with neighbors are critical for the health and well-being of older adults whose social interactions have become more geographically limited. Even though research shows that social cohesion generally increases with household income, a larger portion of older Hispanics and Blacks at every level of income live in low-cohesion neighborhoods than white adults. Low-cohesion was defined based on reported feelings of not belonging in the area, not knowing friendly or trustworthy people, and not knowing people who could help in a time of trouble.
  • Research shows that exposure to air pollution can lead to severe respiratory damage, cause inflammation and blood clots, and damage the structure and function of an aging brain. At every level of income, a larger portion of older Black adults live in high-pollution neighborhoods than do white adults.

Policy implication

  • Efforts to improve aging outcomes need to consider the unequal distribution of older adults in neighborhoods and to address the barriers that may impede neighborhood-based activities. Age-friendly community programs should ensure that all older adults have the opportunity to live in neighborhoods that safeguard and promote their health and well-being.

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