Neighborhood disadvantage is associated with biological aging: Intervention-induced enhancement of couple functioning confers resilience

Abstract

The accelerated pace of biological aging predicts mortality and morbidity later in life. The current study examines whether a change in supportive couple functioning buffers accelerated aging associated with stressful community environments among Black Americans who live in rural, Southern, disadvantaged neighborhoods. We examined 348 Black American middle-aged adults assigned randomly to receive the Protecting Strong African American Families (ProSAAF) intervention or a control condition. The program was designed to enhance supportive couple functioning among Black Americans. We used DunedinPoAm to quantify the methylation pace of aging and employed the Area Deprivation Index at the census block group level to measure neighborhood disadvantage. Neighborhood disadvantage was associated with the accelerated pace of aging. Further, participation in ProSAAF enhanced supportive couple functioning, and improvement in couple functioning protected participants from the harmful effects of neighborhood disadvantage on the accelerated pace of aging. These findings supported mediated moderation and suggested that family-based prevention programs that enhance couple support may decrease the erosive effects of neighborhood disadvantage and improve prospects for healthy aging among rural, Southern, Black Americans living in difficult circumstances. This may provide a supplemental strategy for decreasing health disparities due to neighborhood disadvantage by enhancing family systems.

Keywords: couple functioning; family-based intervention; neighborhood disadvantage; pace of aging; strength and strain; 以家庭为基础的干预; 优势和压力; 伴侣功能; 社区的不利环境; 老龄化速度.

Figure 1.

Theoretical model showing a mediated moderating effect from ProSAAF to Δ couple functioning, which, in turn, significantly interacts with neighborhood disadvantage to buffer its adverse effect on pace of biological aging. Δ = change from baseline to long-term follow-up.

Figure 2.

Effects of neighborhood disadvantage on the pace of biological aging at different levels of change in couple functioning Note: The lines represent the regression lines for different levels of the moderator (declines in couple functioning: 1 SD below the mean; little change in couple functioning: the mean; improvement in couple functioning: 1 SD above the mean). Neighborhoods are classified as having low (the lowest 25th percentile and lower) or high concentrated disadvantage (the highest 75th percentile and higher). Numbers in parentheses refer to simple slopes. * p < .05; ** p < .01 (two-tailed tests), N = 348.

Figure 3.

Mediated moderation model predicting the pace of biological aging as a function of neighborhood disadvantage and ProSAAF, with changes in couple functioning as the mediating variable Note: ${\chi }^2=7.353$, df = 2, p = .025, CFI = .952, RMSEA = .050. Δ = change from baseline to long-term follow-up. Values are standardized parameter estimates. Sex, marital status, income, body mass index, substance use, and cell-type composition are controlled but not shown in the figure. Complex with cluster option in Mplus is used to obtain a robust standard error that adjusts for couple dependence correlation. The bold lines indicate that the indirect effect is significant. * p < .05; ** p < .01 (two-tailed tests), N = 348.