Gram Research analysis of a 2026 cohort study of 2,362 current and former smokers found that living in a more socially disadvantaged neighborhood was linked to faster lung function decline and a 28% higher risk of death from any cause. Smoking habits and diet appear to explain part of this link.
Gram Research analysis of a long-running study of 2,362 current and former smokers suggests that where people live may affect how their lungs age. Researchers tracked participants’ breathing tests from 2001 through 2017 and checked who had died through October 2020. People living in neighborhoods with more social hardship, such as higher poverty and fewer resources, had lungs that lost air-moving capacity faster over time. They also reported worse breathing-related quality of life and had a 28% higher chance of dying from any cause during the study. Smoking habits and diet appeared to explain part of these links, but not all of them. The study cannot prove that neighborhoods cause these effects, yet it highlights why community conditions matter for lung health, especially for people who have smoked.
Key Statistics
A 2026 cohort study of 2,362 current and former smokers found that people in the most socially disadvantaged neighborhoods had a 1.28 times higher risk of death from any cause compared with those in less disadvantaged areas.
In the same 2026 cohort study, people from high-disadvantage neighborhoods lost about 3.11 milliliters more air capacity per year in FEV1, a key lung function measure, than those from less disadvantaged areas.
Researchers found that current smoking status and dietary patterns appeared to account for roughly 4% to 31% of some links between neighborhood disadvantage and lung health, according to the 2026 study of 2,362 participants.
The Quick Take
- What they studied: Researchers asked whether living in a neighborhood with more social problems, such as poverty and limited resources, is linked to faster loss of lung function, lower quality of life, and earlier death in people who have smoked.
- Who participated: The study included 2,362 adults aged 40 to 75 who were current or former smokers with at least 10 pack-years of smoking history. The average age was about 56, and about 74% were women. Participants came from the Lovelace Smokers Cohort in New Mexico.
- Key finding: People in the most socially disadvantaged neighborhoods lost lung function faster each year and had a hazard ratio of 1.28 for death from any cause, meaning about 28% higher risk than people in less disadvantaged areas (95% confidence range of 1.08 to 1.53). The differences were measurable but modest for each individual.
- What it means for you: If you have smoked, your neighborhood may be one of many factors affecting your lungs. Quitting smoking, eating a healthy diet, and asking your doctor about lung checkups are steps that can help regardless of where you live. This study does not prove that moving would change your outcome.
The Research Details
This was a cohort study, meaning researchers followed the same group of people over many years to see what happened to them. Participants were current or former smokers from the Lovelace Smokers Cohort. They completed breathing tests about every 18 months from 2001 through 2017, which allowed researchers to measure how their lung function changed over time.
Each participant’s home address was matched to a census tract, which is a small, defined area used by the U.S. Census. Researchers then used two common measures of neighborhood disadvantage. The Social Vulnerability Index looks at factors such as income, education, housing, and access to transportation. The Social Deprivation Index looks at related factors like poverty, employment, and household conditions. Higher scores on either measure meant more disadvantage.
Researchers also asked participants about their quality of life using standard questionnaires about breathing and daily health. Deaths were checked through the National Death Index, a national government database, through October 2020. Statistical models then tested whether factors such as education, smoking status, and diet could explain part of the links between neighborhood conditions and health.
Following the same people over many years is useful because it shows what happens over time rather than just a single snapshot. Since lung function naturally declines with age, measuring the rate of change helps reveal whether something in the environment is speeding that process. Using repeated breathing tests makes the results more reliable than relying on one measurement.
Using address-based neighborhood measures also lets researchers look at conditions that people share in the same area, such as access to healthy food, safety, and services. Because the study followed people for a long time and checked deaths through a national database, it could track outcomes that matter most to health.
The study has several strengths. It used repeated lung tests, tracked outcomes for many years, relied on a national death database, and used standard tools for measuring neighborhood disadvantage and quality of life. The analysis was also detailed enough to test possible explanations, such as smoking and diet.
Still, readers should keep a few points in mind. Observational studies can show that two things are linked, but they cannot prove one causes the other. The participants were mostly women and all had a substantial smoking history, so results may not apply equally to everyone. Some of the reported links were small, and several confidence ranges were wide, which means the true effects could be somewhat smaller or larger.
What the Results Show
Participants living in neighborhoods with more social disadvantage had lower lung function at the start of the study. The gap was small for each person, but it was consistent across the group. Researchers measured air capacity using a breath test called spirometry, and lower numbers indicate weaker lungs.
Over time, the decline was also faster. People in the most disadvantaged neighborhoods lost about 3.11 milliliters more air capacity per year in one key measure, FEV1, compared with those in less disadvantaged areas. That amount is small in a single year, but it can add up over many years and may matter for people who already have reduced lung function.
Quality of life was also lower. Participants from more disadvantaged neighborhoods had higher scores on the St George’s Respiratory Questionnaire, which means worse breathing-related health. Their scores were about 4.46 points higher on average. They also had a higher risk of death from any cause during follow-up, with a hazard ratio of 1.28.
The study also explored possible reasons for these differences. Current smoking, which is tied to neighborhood conditions in many communities, and two dietary patterns appeared to explain part of the link with lung health. Current smoking alone accounted for roughly 4% to 31% of some associations, and diet accounted for about 4.5% to 17%. The ranges were wide, so these estimates are rough.
Researchers also looked at whether early lung function and quality of life helped explain the higher death rate in disadvantaged neighborhoods. They found that these factors accounted for a portion of the link, with estimates ranging from about 7% to 39% depending on the measure. This suggests that the effects on breathing may be part of the reason for the higher risk of death, although many other factors likely play a role too.
The findings also point to a practical message: people who have smoked and live in high-disadvantage areas may benefit from extra support, such as smoking cessation programs, healthy food access, and regular lung health checks. These outcomes matter because lung health affects daily activities like walking, climbing stairs, and breathing comfortably.
Previous research has linked lower income, limited education, and other neighborhood conditions to poorer heart health, higher rates of chronic disease, and shorter life expectancy. This study adds to that body of work by showing that similar patterns appear in lung health, particularly the speed at which lung function declines.
The results also fit with the broader idea that health is shaped by the places people live, work, and grow up, not only by personal choices or medical care. Gram Research analysis places this study among a growing number of papers showing that community conditions can influence long-term respiratory outcomes.
This study cannot prove that neighborhood conditions directly cause faster lung decline or earlier death. Other factors that were not measured, such as workplace exposures, air pollution at home, access to medical care, or stress, could also play a role.
The group was mostly women, and all participants had a meaningful smoking history, so results may not apply to men, nonsmokers, or people from other regions in the same way. Neighborhood measures are based on census areas, which may not capture each person’s daily experience. The mediation estimates also had wide ranges, meaning the true role of smoking and diet could be much smaller or larger than reported.
The Bottom Line
Research shows that people who have smoked and live in socially disadvantaged neighborhoods may have faster lung decline and a higher risk of death. Quitting smoking is a strong, well-supported step for lung health at any age (high confidence). Eating a diet rich in vegetables, fruits, and whole grains may also support lung and overall health (moderate confidence). Regular checkups with a doctor and asking about local lung health resources are reasonable steps (moderate confidence). Whether neighborhood changes alone would improve lung outcomes is not yet proven (low confidence).
This research is most relevant to adults who have smoked, especially those aged 40 to 75, and to public health workers, community planners, and healthcare providers who serve people in high-disadvantage areas. People who have never smoked or who are younger than 40 may find the findings less directly applicable, though the broader message about environmental influences on health still matters. Anyone with breathing concerns should talk with a doctor before making changes.
Quitting smoking can begin improving lung function within weeks, and risk of heart and lung disease drops substantially over the first few years. Dietary changes may take months to show measurable effects. Changes in neighborhood conditions usually happen over many years, and the link between those changes and lung health would need long-term research to confirm.
Frequently Asked Questions
Does living in a poor neighborhood affect your lungs?
A 2026 cohort study of 2,362 smokers found that people in more socially disadvantaged neighborhoods lost lung function faster each year. Their breathing-related quality of life was also lower. The study shows an association, not proof that neighborhoods directly cause lung damage.
Can a healthy diet help protect lungs in people who have smoked?
Research reviewed by Gram suggests that certain dietary patterns may partly explain the link between neighborhood disadvantage and lung health. Eating more vegetables, fruits, and whole grains is generally linked to better health. Quitting smoking remains the most important step for protecting lung function.
How much does neighborhood disadvantage raise the risk of early death?
In a study of 2,362 current and former smokers followed through 2020, people in the most disadvantaged neighborhoods had a hazard ratio of 1.28. This means about a 28% higher risk of death from any cause compared with less disadvantaged areas, based on the study’s statistical model.
What can I do to protect my lungs if I used to smoke?
Staying off cigarettes is the most effective step, and lung function may begin improving within weeks. Regular checkups, eating a diet rich in produce, and staying physically active also support lung health. Talk with a doctor about breathing tests, especially if you have symptoms.
Want to Apply This Research?
- Log your smoking status monthly, including the number of cigarettes or days smoke-free, and record your servings of fruits and vegetables each day. If you have a home spirometer or your doctor provides breathing test results, record those readings with dates so you can see trends over time.
- Set a weekly goal to add one extra serving of vegetables or fruit to your meals, and use the app to check off each day you meet it. If you smoke, use the app to set a quit date, track smoke-free days, and connect to local cessation resources or a quitline.
- Review your logs every three months and compare smoking status, diet scores, and any breathing test results. Schedule routine checkups with your doctor at least once a year, and bring your app data to visits so you can discuss patterns and next steps together.
This article summarizes a single observational cohort study and is for general education only. It does not provide medical advice. The findings show associations between neighborhood conditions and lung health, not proof of cause and effect. If you have breathing problems, a history of smoking, or concerns about your lungs, talk with a qualified healthcare provider before making changes to your health routine.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.