Are There Unhealthy Cities? The Impact of Metropolitan Context on Health in Late Middle Age

Recently, several authors have argued that individual health is shaped in part by the characteristics of the cities in which individuals live. Particular attention has been devoted to metropolitan income distribution, residential segregation, and employment conditions. While these ideas are compelling, they have yet to be adequately tested. I expand on previous research in four ways. First, I use multilevel data that includes characteristics of both individuals and the cities in which they live. Second, my data are longitudinal, tracing the health impact of metropolitan context over a 4-year period. Third, I examine several dimensions of health. Finally, I focus on a narrow age range. Data for my analysis are drawn from waves 1-3 of the Health and Retirement Study, an ongoing longitudinal survey of persons born between 1931 and 1941. I limit my analysis to respondents living in metropolitan areas, yielding an effective sample size of approximately 6,900 persons. I appended data characterizing respondents' metropolitan areas, drawn from a variety of sources, to their individual data records. I use hierarchical linear modeling to examine the impact of metropolitan characteristics on self-rated health, presence of a mobility limitation, depressive symptoms, and presence of a chronic disease.

Metropolitan Areas/Urban Population/Health/Health Problems/Social Environment/Middle Aged Adults

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