Importance Neighborhood disadvantage is a novel social determinant of health that could adversely affect the functional well-being of older persons. Deficiencies in resource-poor environments can potentially be addressed through social and public health interventions. Objective To evaluate whether estimates of active and disabled life expectancy differ on the basis of neighborhood disadvantage after accounting for individual-level socioeconomic characteristics and other prognostic factors. Design, Setting, and Participants This prospective longitudinal cohort study included 754 nondisabled community-living persons, aged 70 years or older, who were members of the Precipitating Events Project in south central Connecticut from March 1998 to June 2020. Main Outcomes and Measures Disability in 4 essential activities of daily living (bathing, dressing, walking, and transferring) was assessed each month. Scores on the Area Deprivation Index, a census-based socioeconomic measure with 17 education, employment, housing quality, and poverty indicators, were obtained through linkages with the 2000 Neighborhood Atlas. Area Deprivation Index scores were dichotomized at the 80th state percentile to distinguish neighborhoods that were disadvantaged (81-100) from those that were not (1-80). Results Among the 754 participants, the mean (SD) age was 78.4 (5.3) years, and 487 (64.6%) were female. Within 5-year age increments from 70 to 90, active life expectancy was consistently lower in participants from neighborhoods that were disadvantaged vs not disadvantaged, and these differences persisted and remained statistically significant after adjustment for individual-level race and ethnicity, education, income, and other prognostic factors. At age 70 years, adjusted estimates (95% CI) for active life expectancy (in years) were 12.3 (11.5-13.1) in the disadvantaged group and 14.2 (13.5-14.7) in the nondisadvantaged group. At each age, participants from disadvantaged neighborhoods spent a greater percentage of their projected remaining life disabled, relative to those from nondisadvantaged neighborhoods, with adjusted values (SE) ranging from 17.7 (0.8) vs 15.3 (0.5) at age 70 years to 55.0 (1.7) vs 48.1 (1.3) at age 90 years. Conclusions and Relevance In this prospective longitudinal cohort study, living in a disadvantaged neighborhood was associated with lower active life expectancy and a greater percentage of projected remaining life with disability. By addressing deficiencies in resource-poor environments, new or expanded social and public health initiatives have the potential to improve the functional well-being of community-living older persons and, in turn, reduce health disparities in the US.

中文翻译：

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社区生活中老年人的邻里劣势与功能健康之间的关联。

重要性 邻里劣势是一种新的健康社会决定因素，可能对老年人的功能健康产生不利影响。资源贫乏环境中的缺陷可以通过社会和公共卫生干预来解决。目的 在考虑个人水平的社会经济特征和其他预后因素后，评估活动和残疾人预期寿命的估计是否因邻里劣势而不同。设计、地点和参与者 这项前瞻性纵向队列研究包括 754 名年龄在 70 岁或以上的非残疾社区生活者，他们是 1998 年 3 月至 2020 年 6 月在康涅狄格州中南部的突发事件项目的成员。日常生活的 4 项基本活动（洗澡、每月评估穿衣、行走和转移）。地区剥夺指数是一项基于人口普查的社会经济指标，包含 17 个教育、就业、住房质量和贫困指标，通过与 2000 年社区地图集的联系获得。地区剥夺指数分数在第 80 个州百分位被二分，以区分处于不利地位的社区 (81-100) 和不处于不利地位的社区 (1-80)。结果 754 名参与者中，平均 (SD) 年龄为 78.4 (5.3) 岁，其中女性 487 (64.6%) 名。在从 70 岁到 90 岁的 5 岁增量中，来自处于不利地位的社区与非处于不利地位的社区的参与者的积极预期寿命始终较低，并且这些差异持续存在，并且在调整个人水平的种族和民族后仍然具有统计学意义，教育、收入和其他预后因素。在 70 岁时，活动预期寿命（年）的调整估计值（95% CI）在弱势群体中为 12.3（11.5-13.1），在非弱势群体中为 14.2（13.5-14.7）。在每个年龄，相对于非贫困社区的参与者，来自贫困社区的参与者在他们预计的剩余生命中残疾的比例更高，调整后的值 (SE) 从 17.7 (0.8) 到 70 岁时的 15.3 (0.5) 到 55.0 ( 1.7) 与 90 岁时的 48.1 (1.3)。结论和相关性 在这项前瞻性纵向队列研究中，生活在贫困社区与较低的活动预期寿命和较高的残障人士预计剩余寿命相关。通过解决资源匮乏环境中的缺陷，