Abstract PR-10: The association of neighborhood socioeconomic context and mortality in a large national cohort in the United States: The NIHA-ARP Diet and Health Study

Abstract

Abstract Background: Although several studies have reported that persons from lower socioeconomic groups have poorer health outcomes, few prospective studies have examined whether neighborhood socioeconomic context is associated with mortality. In this study, we prospectively evaluated whether persons residing in socioeconomically deprived neighborhoods have higher mortality risk compared to more resourced neighborhoods among a large geographically dispersed cohort. Methods: Between 1995 and 1996, the NIH-AARP Diet and Health Study recruited an ethnically diverse prospective cohort of 566,402 persons, 50–71 years of age, from six U.S. states and two metropolitan areas. Detailed data were collected on diet, lifestyle, and medical history through questionnaires. Neighborhood socioeconomic information was obtained through linkage to the 2000 U.S. Census data at the tract level. We excluded 705 subjects with incomplete information for geocoding and computed an empirically derived index of neighborhood socioeconomic deprivation using principal component analyses. Mortality was ascertained through December 31, 2006. Two-level continuous-time survival models were used to derive hazard ratios of time to death from any cause stratified by gender. Results: Of the 565,697 eligible subjects at baseline, the mean age was 62 years, 60% were male, 91% were non-Hispanic whites, 4% non-Hispanic blacks and 9% reported a history of cancer. A higher percentage of those in the most deprived neighborhoods reported poorer general health, higher average BMI, and lower Mediterranean diet scores. In multilevel Cox models analyses controlling for dietary and lifestyle factors, the risk of death increased with increasing levels of deprivation in the neighborhood of residence. Compared to the least deprived neighborhood, those residing in areas in the highest quintile of deprivation had a higher risk for death (men: hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.18–1.25); women: HR: 1.23, 95% CI: 1.17–1.29). Conclusion: Our study suggests that living in socioeconomically deprived neighborhoods is associated with a higher risk for death independent of lifestyle and dietary risk factors. Citation Information: Cancer Prev Res 2010;3(1 Suppl):PR-10.