Differential expression of lymphocyte markers by neighborhood opportunity among US adults: Insights from the Midlife in the United States study.

Social and environmental neighborhood characteristics play important roles in promoting opportunities for healthy living. However, access to quality opportunities vary depending on where people live, largely due to structural injustices perpetuating inequities. Though the impacts of such injustices on physiological health outcomes are well-studied, little is known about how the underlying biological mechanisms facilitating these health outcomes may be influenced by constructs of neighborhood opportunity. To further investigate the relationship between neighborhood opportunity and immunoregulation, we used data from the Midlife in the United States study (n = 1215; mean age 56.9 years, SD = 12.2; 53.2% female, 73.0% non-Hispanic White) and the Child Opportunity Index 3.0 to examine how neighborhood opportunity may be associated with differing expression levels of CD19 and CD3, canonical lineage markers for B and T cells. Primary analyses found that living in low Overall Neighborhood Opportunity areas was associated with significantly higher expression of CD3 (38.5% elevation; 95% CI: 14.9%, 68.2%; p < 0.001) compared to high opportunity areas, adjusting for sociodemographic characteristics, health-related measures, and lifestyle factors. Secondary analyses of neighborhood opportunity subdomains found that higher CD3 expression was significantly associated with low levels of Education Opportunity (32.9% elevation; 95% CI: 10.2%, 59.1%; p = 0.003) and Social and Economic Resources Opportunity (38.5% elevation; 95% CI: 14.9%, 68.2%; p < 0.001) compared to in high opportunity areas. These results suggest that social and educational neighborhood environments may play a role as social determinants of biological health, pointing to potential immunologic pathways through which neighborhood opportunity impacts health.