Health Status, Neighborhood Socioeconomic Context, and Premature Mortality in the United States: The National Institutes of Health-AARP Diet and Health Study

UMMS Affiliation

Department of Family Medicine and Community Health; Meyers Primary Care Institute; Department of Psychiatry

Publication Date


Document Type



Socioeconomic Factors; Residence Characteristics; Mortality, Premature; Health Status


Community Health and Preventive Medicine | Preventive Medicine | Primary Care


Objectives. We examined whether the risk of premature mortality associated with living in socioeconomically deprived neighborhoods varies according to the health status of individuals.

Methods. Community-dwelling adults (n=566402; age=50-71 years) in 6 US states and 2 metropolitan areas participated in the ongoing prospective National Institutes of Health-AARP Diet and Health Study, which began in 1995. We used baseline data for 565679 participants on health behaviors, self-rated health status, and medical history, collected by mailed questionnaires. Participants were linked to 2000 census data for an index of census tract socioeconomic deprivation. The main outcome was all-cause mortality ascertained through 2006.

Results. In adjusted survival analyses of persons in good-to-excellent health at baseline, risk of mortality increased with increasing levels of census tract socioeconomic deprivation. Neighborhood socioeconomic mortality disparities among persons in fair-to-poor health were not statistically significant after adjustment for demographic characteristics, educational achievement, lifestyle, and medical conditions.

Conclusions. Neighborhood socioeconomic inequalities lead to large disparities in risk of premature mortality among healthy US adults but not among those in poor health. (Am J Public Health. Published online ahead of print August 18, 2011: e1-e9. doi:10.2105/AJPH.2011.300158).

DOI of Published Version



Am J Public Health. 2012 Apr;102(4):680-8. Epub 2011 Nov 28. Link to article on publisher's site

Journal/Book/Conference Title

American journal of public health

Related Resources

Link to Article in PubMed

PubMed ID