Neighborhood conditions and physical health, neurocognitive, and academic outcomes in youth with spina bifida

OBJECTIVE: This study examines associations between geocoded neighborhood conditions and health, neurocognitive, and academic outcomes among youth with spina bifida (SB). METHODS: Addresses of youth with SB living in the Midwest (N = 130, Mage= 11.5 ± 2.5; 53.8% female; 51.5% non-Hispanic White) were geocoded based on census tracts and linked to state-normed Child Opportunity Index (COI) scores. Youth completed performance-based measures of attention, intelligence, working memory, cognitive flexibility, and academic achievement. Parents and teachers completed standardized questionnaires assessing attention, executive functioning, academic achievement, and academic competence. Parents also reported health complications (e.g., shunt revisions, urinary tract infections). Regression analyses controlled for age and lesion level. RESULTS: COI scores were significantly and positively associated with youth attention, working memory, intelligence, cognitive flexibility and academic achievement, but not with health complications or inhibition. CONCLUSIONS: Neighborhood factors were significantly associated with several neurocognitive and academic subdomains in youth with SB. These results highlight the importance of devoting resources to better serve youth with SB living in lower-opportunity neighborhoods and can be used to support systems and policies driving equitable outcomes for these youth.