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. 2016 Apr 21;26(2):157-64.
doi: 10.18865/ed.26.2.157.

Neighborhood Socioeconomic Status in Relation to All-Cause, Cancer, and Cardiovascular Mortality in the Black Women's Health Study

Traci N Bethea  1 , Julie R Palmer  1 , Lynn Rosenberg  1 , Yvette C Cozier  1
Affiliations

Neighborhood Socioeconomic Status in Relation to All-Cause, Cancer, and Cardiovascular Mortality in the Black Women's Health Study

Traci N Bethea et al. Ethn Dis. .

Abstract

Background: Neighborhood socioeconomic status (SES) is associated with adverse health outcomes, but longitudinal data among Black Americans, who tend to live in more deprived neighborhoods, is lacking.

Objective: We prospectively assessed the relation of neighborhood SES to mortality in the Black Women's Health Study.

Design: A prospective cohort of 59,000 Black women was followed from 1995-2011. Participant addresses were geocoded and US Census block group was identified. Neighborhood SES was measured by a score based on US Census block group data for six indicators of income, education and wealth.

Main outcome measures: Deaths were identified through the National Death Index. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% CIs with control for covariates.

Results: Based on 2,598 deaths during 1995-2011, lower neighborhood SES was associated with increased all-cause and cancer mortality irrespective of individual education: among those with 16 or more years of education, HRs for lowest relative to highest neighborhood SES quartile were 1.42 (95% CI 1.18-1.71) for all-cause and 1.54 (95% CI 1.14-2.07) for cancer mortality. Neighborhood SES was associated with cardiovascular mortality among less-educated women.

Conclusions: Lower neighborhood SES is associated with greater risk of mortality among Black women. The presence of the association even among women with high levels of education suggests that individual SES may not overcome the unfavorable influence of neighborhood deprivation.

Keywords: African Americans; Longitudinal Studies; Mortality; Residence Characteristics; Socioeconomic Factors.

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Conflict of interest statement

We have no conflicts of interest to disclose. The Black Women’s Health Study was approved by the Boston University Medical Center Institutional Review Board and all procedures were conducted in accord with the ethical standards of the Institutional Review Board and the Helsinki Declaration of 1975, as revised in the year 2000. Each BWHS participant provided informed consent.

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