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. 2008 Sep;14(3):453-67.
doi: 10.1016/j.healthplace.2007.09.004. Epub 2007 Sep 21.

Evaluating options for measurement of neighborhood socioeconomic context: evidence from a myocardial infarction case-control study

Gina S Lovasi  1 , Anne Vernez Moudon, Nicholas L Smith, Thomas Lumley, Eric B Larson, Dong W Sohn, David S Siscovick, Bruce M Psaty
Affiliations

Evaluating options for measurement of neighborhood socioeconomic context: evidence from a myocardial infarction case-control study

Gina S Lovasi et al. Health Place. 2008 Sep.

Abstract

We hypothesized that neighborhood socioeconomic context would be most strongly associated with risk of myocardial infarction (MI) for smaller "neighborhood" definitions. We used data on 487 non-fatal, incident MI cases and 1873 controls from a case-control study in Washington State. Census data on income, home ownership, and education were used to estimate socioeconomic context across four neighborhood definitions: 1 km buffer, block group, census tract, and ZIP code. No neighborhood definition led to consistently stronger associations with MI. Although we confirmed the association between neighborhood socioeconomic measures and risk of MI, we did not find these associations sensitive to neighborhood definition.

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Figures

Figure 1
Figure 1. Illustration of Selected Scales of Socioeconomic Context Measurement
Four scales were considered for measurement of “neighborhood” socioeconomic characteristics. As illustrated here, ZIP codes were the largest area considered, with boundaries that do not necessarily correspond to the census area boundaries. Census tracts were divided into smaller census block groups. One-kilometer airline buffers were by definition circular and of a fixed size, while for other neighborhood definitions the shape and size varied.
Figure 2
Figure 2. Study Addresses and Socioeconomic Characteristics in the Puget Sound Region of Washington State
Address locations (a) have been jittered to protect participant confidentiality; median household income (b), proportion of individuals below the federal poverty line (c), proportion of homes that were owner-occupied (d), proportion of adults who graduated from high school (e) and proportion of adults who graduated from college (f) are shown for census block groups, with darker shades indicate census block groups with higher socioeconomic status (higher median household income, less poverty, more home ownership, higher educational attainment), approximately equal area for each of 10 shades
Figure 3
Figure 3. Odds Ratios for Myocardial Infarction by Quartiles of Neighborhood Socioeconomic Characteristics
Models were adjusted for matching variables (age, sex, hypertension status, calendar year) and demographic characteristics (marital status, and race); pseudo r-squared values for these logistic regression models are shown
Figure 4
Figure 4. Odds Ratios for Myocardial Infarction by Quartiles of Neighborhood Socioeconomic Characteristics Adjusted for Individual Socioeconomic Characteristics
Models were adjusted for matching variables (age, sex, hypertension status, calendar year) and individual socioeconomic/demographic characteristics (household income, education, employment/retirement status, marital status, and race); pseudo r-squared values for these logistic regression models are shown
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