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Primary Submission Category: Place/Communities
Neighborhood Context and Physical Disability: Preliminary Results from a Systematic Review
Authors: Laura Stoff, Lauren Love Pieczykolan, Nicole Theis-Mahon, Carrie Henning-Smith, Theresa Osypuk,
Presenting Author: Laura Stoff*
An estimated 16% of the global population and 29% of people in the United States live with a physical disability, commonly conceptualized as limitations in activities of daily living (ADLs) and instrumental ADLs (IADLs). While neighborhood disadvantage is a well-established risk factor for chronic disease, less research focuses on its relationship with disability. Neighborhood may play a role in the development or progression of disability through mechanisms that are different from those that explain its relationship with other health outcomes. This study aims to examine how neighborhood contexts are associated with ADL/IADL disability among community-dwelling adults.
We conducted a systematic review to identify and synthesize evidence on area-level neighborhood characteristics—including socioeconomic context, social context (e.g., cohesion, safety), and built/physical environment (e.g., walkability, transit access)—associated with ADL/IADL disability outcomes. Eligible studies included peer-reviewed observational and quasi-experimental designs of adults (≥18 years) in community settings worldwide, with individual-level ADL/IADL outcomes. Two reviewers independently screened articles, extracted information, and assessed risk of bias.
Preliminary findings indicate that most studies report neighborhood disadvantage is associated with increased risk or burden of disability. However, there is heterogeneity across studies in how both neighborhood context and disability are operationalized, including variation in geographic scale, use of subjective vs. objective measures, and measures included in ADL/IADL instruments. This presentation will synthesize these findings by summarizing patterns across studies, highlighting key measurement differences, and discussing implications for future research on neighborhood context and disability, in order to reimagine challenges for population health science.