There is an overreliance on concurrent neighbourhood deprivation as a determinant of health. Only a small section of the literature focuses on the cumulative exposure of neighbourhood deprivation over the life course. This paper uses data from the 1958 National Child Development Study, a British birth cohort study, linked to 1971-2011 Census data at the neighbourhood level to longitudinally model self-rated health between ages 23 and 55 by Townsend deprivation score between ages 16 and 55. Change in self-rated health is analysed using ordinal multilevel models to test the strength of association with neighbourhood deprivation at age 16, concurrently and cumulatively. The results show that greater neighbourhood deprivation at age 16 predicts worsening self-rated health between ages 33 and 50. The association with concurrent neighbourhood deprivation is shown to be stronger compared with the measurement at age 16 when both are adjusted in the model. The concurrent association with change in self-rated health is explained by cumulative neighbourhood deprivation. These findings suggest that neglecting exposure to neighbourhood deprivation over the life course will underestimate the neighbourhood effect. They also have potential implications for public policy suggesting that neighbourhood socioeconomic equality may bring about better population health.
Keywords: Townsend index; cumulative effects; life course epidemiology; multilevel modelling; neighbourhood deprivation; neighbourhood effects; self-rated health.