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.
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.
Authors: Karin Nelson; Leslie Taylor; Nicole Lurie; José Escarce; Lynne McFarland; Stephan D Fihn Journal: J Gen Intern Med Date: 2011-04-16 Impact factor: 5.128
Authors: Amy J Schulz; Graciela Mentz; Laurie Lachance; Jonetta Johnson; Causandra Gaines; Barbara A Israel Journal: Am J Public Health Date: 2012-02-16 Impact factor: 9.308
Authors: David H Rehkopf; Lorna T Haughton; Jarvis T Chen; Pamela D Waterman; S V Subramanian; Nancy Krieger Journal: Am J Public Health Date: 2006-06-29 Impact factor: 9.308
Authors: Emily Russell; Michael R Kramer; Hannah L F Cooper; Winifred Wilkins Thompson; Kimberly R Jacob Arriola Journal: J Urban Health Date: 2011-12 Impact factor: 3.671
Authors: Yvette C Cozier; Julie R Palmer; Nicholas J Horton; Lisa Fredman; Lauren A Wise; Lynn Rosenberg Journal: Am J Public Health Date: 2007-02-28 Impact factor: 9.308
Authors: Ana V Diez Roux; Luisa N Borrell; Mary Haan; Sharon A Jackson; Richard Schultz Journal: J Epidemiol Community Health Date: 2004-11 Impact factor: 3.710
Authors: Lynn Rosenberg; Yvonne P Robles; Shanshan Li; Edward A Ruiz-Narvaez; Julie R Palmer Journal: Am J Clin Nutr Date: 2020-09-01 Impact factor: 7.045
Authors: Shaneda Warren Andersen; William J Blot; Xiao-Ou Shu; Jennifer S Sonderman; Mark Steinwandel; Margaret K Hargreaves; Wei Zheng Journal: Am J Prev Med Date: 2018-01 Impact factor: 5.043
Authors: Tomi Akinyemiju; Kemi Ogunsina; Michelle Okwali; Swati Sakhuja; Dejana Braithwaite Journal: Int J Cancer Date: 2016-11-18 Impact factor: 7.396
Authors: Andrew Edmonds; Alexander Breskin; Stephen R Cole; Daniel Westreich; Catalina Ramirez; Jennifer Cocohoba; Gina Wingood; Mardge H Cohen; Elizabeth T Golub; Seble G Kassaye; Lisa R Metsch; Anjali Sharma; Deborah Konkle-Parker; Tracey E Wilson; Adaora A Adimora Journal: Epidemiology Date: 2021-11-01 Impact factor: 4.860