Abstract
BACKGROUND: Lower neighborhood socioeconomic status (SES) and decline in neighborhood SES have been linked to detrimental health outcomes, such as cardiovascular disease (CVD), cancer, and mortality. However, few studies have investigated distinct types of neighborhood economic trajectories in relation to mortality. We examined the association between the recently developed multidimensional measure of neighborhood trajectories and mortality in older adults enrolled in the National Institutes of Health-AARP Diet and Health Study (NIH-AARP). METHODS: Neighborhoods were classified into five groups based on economic change patterns from 2000 to 2016 using American Community Survey data: Stability, Growth, Displacement, Abandonment, and Poverty Concentration. Mortality outcomes—including all-cause, CVD, and cancer mortality—were identified using ICD-10 Causes of Death Recodes. We applied Cox proportional hazards regression to analyze neighborhood trajectories and mortality outcomes in 452,624 participants. RESULTS: Among 452,624 participants, (mean age = 61.5 (5.4) years) poverty concentration (HR = 1.07, 95% CI: 1.06–1.08), abandonment (HR = 1.14, 95% CI: 1.09–1.19), and displacement (HR = 1.03, 95% CI: 1.00–1.05) were significantly associated with all-cause mortality. Similarly, poverty concentration (HR = 1.09, 95% CI: 1.07–1.11), abandonment (HR = 1.26, 95% CI: 1.17–1.37), and displacement (HR = 1.07, 95% CI: 1.02–1.11) were significantly associated with CVD mortality. No significant associations were found with cancer mortality (p > 0.05). CONCLUSIONS: Our findings suggested a link between long-term neighborhood trajectories and mortality outcomes, highlighted the importance of considering the multidimensionality in neighborhood SES, and emphasized the need for area-level interventions to mitigate health disparities in vulnerable communities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-025-01822-x.