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Multicenter Study
. 2012 Apr;102(4):680-8.
doi: 10.2105/AJPH.2011.300158. Epub 2011 Nov 28.

Health status, neighborhood socioeconomic context, and premature mortality in the United States: The National Institutes of Health-AARP Diet and Health Study

Chyke A Doubeni  1 , Mario Schootman, Jacqueline M Major, Rosalie A Torres Stone, Adeyinka O Laiyemo, Yikyung Park, Min Lian, Lynne Messer, Barry I Graubard, Rashmi Sinha, Albert R Hollenbeck, Arthur Schatzkin
Affiliations
Multicenter Study

Health status, neighborhood socioeconomic context, and premature mortality in the United States: The National Institutes of Health-AARP Diet and Health Study

Chyke A Doubeni et al. Am J Public Health. 2012 Apr.

Abstract

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 = 566,402; 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 565,679 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.

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Figures

FIGURE 1
FIGURE 1
Age- and gender-adjusted cumulative mortality rate plots for all-cause mortality according to health status and neighborhood socioeconomic deprivation: The National Institutes of Health–AARP Diet and Health Study, 1995–2006. Note. Least deprived is first quintile; most deprived is fifth quintile. Curves were obtained from fixed-effect Cox models stratified on health status and deprivation index as appropriate and were adjusted for age, gender, marital status, race/ethnicity, and state of residence health status. Higher curves correspond to higher mortality rates.
See this image and copyright information in PMC

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