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Abstract
BackgroundSocial determinants of health (SDOH) contribute to unequal life expectancy (LE). Only a handful of papers have analyzed these relationships at the neighborhood level as opposed to the county level. This study draws on both the SDOH and social vulnerability literature to identify relevant factors affecting LE.MethodsLE was calculated from mortality records for Florida from 2009 to 2013 for 3640 census tracts with reliable estimates. A spatial Durbin error model (SDEM) quantified the direction and magnitude of the factors to LE. The SDEM contains a spatial error term and jointly estimates both local and neighborhood associations. This methodology controls for non-independence between census tracts to provide unbiased statistical estimates.ResultsFactors significantly related to an increase in LE, include percentage (%) of the population who identify as Hispanic (beta coefficient [β]: 0.06, p-value [P] < 0.001) and % of age dependent populations (% population < 5 years old and % population > 65) (β: 0.13, P < 0.001). Conversely, the following factors exhibited significant negative LE associations, % of households with no automobile (β: -0.05, P < 0.001), % of mobile homes (β: -0.02, P < 0.001), and % of female headed households (β: -0.11, P < 0.001).ConclusionsResults from the SDEM demonstrate social vulnerability indicators account for additional geographic LE variability beyond commonly studied SDOH. Empirical findings from this analysis can help local health departments identify drivers of spatial health disparities at the local level.
Highlights
Social determinants of health (SDOH) contribute to unequal life expectancy (LE)
This study draws on a social vulnerability dataset detailing factors meant to indicate which population groups are at risk to be harmed by natural and/or human caused disasters in Florida to more precisely characterize differences in life expectancy
Recent studies have analyzed county level SDOH and LE [8, 9]. This study examines both SDOH and social vulnerability indicators to provide a multifaceted analysis of health disparities
Summary
Social determinants of health (SDOH) contribute to unequal life expectancy (LE). This study draws on both the SDOH and social vulnerability literature to identify relevant factors affecting LE. Life expectancy (LE) is defined as the number of years an average individual can expect to live given existing age-specific death rates [1]. This indicator is understood by policy makers and the general public and allows for direct comparisons across space and time. Public health studies use a social determinants of health (SDOH) framework to identify the most important factors affecting LE [2,3,4,5]
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