Accounting for Time and Life Course Effects

Although a number of longitudinal studies of neighborhood health effects have been published (Auchincloss et al, 2009; Diez Roux, 2001; Sundquist et al, 2004), most studies in neighborhood health effects are cross-sectional and measure neighborhood exposures and health outcomes at a single point in time. In addition to the inability to avoid endogeneity (i.e., the possibility that health is causally related to residential location), these studies are unable to answer questions regarding the timescale over which neighborhood health effects operate or the time lags involved. Some concerns regarding endo-geneity are addressed with the increasing number of cohort studies that have examined neighborhood environments in relation to changes in health behaviors or conditions over time or in relation to incident disease (Auchincloss et al, 2009; Diez Roux, 2001; Mujahid et al, 2005; Sundquist et al, 2004). However, these studies often do not provide any insight into the timescales most relevant for neighborhood health effects, especially for conditions that are chronic in nature and develop over long periods. Moreover, few studies have investigated neighborhood environment over the life course (Chichlowska et al, 2009; Pollitt et al, 2007, 2008). Future research may benefit from investigations of neighborhood environments early in the life course in addition to the cumulative effect of neighborhood environments in relation to health.

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