Department of Family Medicine and Community Health; Meyers Primary Care Institute
Aged; Cardiovascular Diseases; Educational Status; Female; Health Status; Humans; Longitudinal Studies; Male; Middle Aged; Mortality; Multivariate Analysis; National Institutes of Health (U.S.); Neoplasms; Nutrition Assessment; Principal Component Analysis; Proportional Hazards Models; Questionnaires; *Residence Characteristics; Risk Assessment; Risk Factors; Social Class; Socioeconomic Factors; United States
PURPOSE: Residing in deprived areas may increase risk of mortality beyond that explained by a person's own SES-related factors and lifestyle. The aim of this study was to examine the relation between neighborhood socioeconomic deprivation and all-cause, cancer- and cardiovascular disease (CVD)-specific mortality for men and women after accounting for education and other important person-level risk factors.
METHODS: In the longitudinal NIH-AARP Study, we analyzed data from healthy participants, ages 50-71 years at study baseline (1995-1996). Deaths (n = 33831) were identified through December 2005. Information on census tracts was obtained from the 2000 US Census. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for quintiles of neighborhood deprivation.
RESULTS: Participants in the highest quintile of deprivation had elevated risks for overall mortality (HR(men) = 1.17, 95% CI: 1.10, 1.24; HR(women) = 1.13, 95% CI: 1.05, 1.22) and marginally increased risk for cancer deaths (HR(men) = 1.09, 95% CI: 1.00, 1.20; HR(women) = 1.09, 95% CI: 0.99, 1.22). CVD mortality associations appeared stronger in men (HR = 1.33, 95% CI: 1.19, 1.49) than women (HR = 1.18, 95% CI: 1.01, 1.38). There was no evidence of an effect modification by education.
CONCLUSION: Higher neighborhood deprivation was associated with modest increases in all-cause, cancer- and CVD-mortality after accounting for many established risk factors.
Rights and Permissions
This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
DOI of Published Version
Jacqueline M. Major, Chyke A. Doubeni, Neal D. Freedman, Yikyung Park, et al.. "Neighborhood socioeconomic deprivation and mortality: NIH-AARP diet and health study" Vol. 5 Iss. 11 (2010) ISSN: 1932-6203 (Linking)
Available at: http://works.bepress.com/chyke_doubeni/8/