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
Community Health and Preventive Medicine | Preventative Medicine | Primary Care
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.
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Citation: PLoS One. 2010 Nov 23;5(11):e15538. Link to article on publisher's site