Abstract
BackgroundLow individual-level socioeconomic status (SES) is associated with higher prevalence of cigarette smoking. Recent work has examined whether neighborhood-level SES may affect smoking behavior independently from individual-level measures. However, few comparisons of neighborhood-level effects on smoking by race and gender are available.MethodsCross-sectional data from adults age 40-79 enrolled in the Southern Community Cohort Study from 2002-2009 (19, 561 black males; 27, 412 black females; 6, 231 white males; 11, 756 white females) were used in Robust Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CI) for current smoking in relation to individual-level SES characteristics obtained via interview and neighborhood-level SES characteristics represented by demographic measures from US Census block groups matched to participant home addresses.ResultsSeveral neighborhood-level SES characteristics were modestly associated with increased smoking after adjustment for individual-level factors including lower percentage of adults with a college education and lower percentage of owner-occupied households among blacks but not whites; lower percentage of households with interest, dividends, or net rental income among white males; and lower percentage of employed adults among black females.ConclusionsLower neighborhood-level SES is associated with increased smoking suggesting that cessation programs may benefit from targeting higher-risk neighborhoods as well as individuals.
Highlights
Low individual-level socioeconomic status (SES) is associated with higher prevalence of cigarette smoking
In the United States, various measures of lower neighborhoodlevel SES have been associated with increased smoking prevalence in a study of young black and white adults [5], in small study populations in North Carolina [7] and Illinois [4], in a large national sample of black women [8], and in participants residing in four communities in the Atherosclerosis Risk in Communities (ARIC) study [13]
Of the 72, 615 participants enrolled in the Southern Community Cohort Study (SCCS) via Community Health Center (CHC) from 2002-2009, 64, 960 (19, 561 black males, 27, 412 black females, 6, 231 white males, and 11, 756 white females) were included in the final analysis
Summary
Low individual-level socioeconomic status (SES) is associated with higher prevalence of cigarette smoking. Low individual socioeconomic status (SES) is strongly associated with increased smoking prevalence across race and behaviors above and beyond the influences of individual SES through these mechanisms or other pathways yet to be determined, novel public health interventions to reduce smoking initiation and encourage smoking cessation may be developed to target high-risk neighborhoods as well as individuals. Before such interventions can be developed and appropriately tailored, research is needed to determine whether differences exist in the effects of neighborhood characteristics across race and gender groups. To improve upon the limited comparisons across race and gender groups in these studies, we examined associations between current cigarette smoking and both individual-level and neighborhood-level characteristics in a large group of black and white adults age 40-79 living in twelve states in the southeastern US
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