Effect Of Neighborhood Deprivation Research Articles

The impact of neighborhood deprivation on mental health and quality of life in children and adolescents during the COVID-19 pandemic: Findings from the COPSY Hamburg study.

Socioeconomic inequalities have been associated with poorer mental health outcomes in children and adolescents during the COVID-19 pandemic. Despite numerous studies on individual risk factors, the impact of societal environment, such as neighborhood characteristics, on changes in mental health has rarely been investigated. This study investigates the effect of neighborhood deprivation on mental health problems and health-related quality of life (HRQoL) in children and adolescents during the COVID-19 pandemic in Hamburg, Germany. Data were derived from the prospective German COPSY Hamburg study. Children and adolescents aged between 11-20 years and their parents participated in the study, which took place in summer 2020 (T1) and summer 2022 (T2). Neighborhood deprivation was assessed by a neighborhood status index. Mental health problems and HRQoL were assessed using internationally validated and established instruments. The prevalence of mental health problems and impaired HRQoL was reported. Analysis of covariance was conducted to examine the effect of neighborhood deprivation of the districts in Hamburg on the (changes in) mental health problems and HRQoL while controlling for social individual-level indicators. The total sample included in the statistical analysis consisted of N = 2,645 families. Children and adolescents living in more deprived areas had higher levels of general mental health problems and depressive symptoms during the COVID-19 pandemic. However, differences in neighborhood deprivation did not relate to the HRQoL and the averaged changes in children and adolescents' mental health problems and HRQoL from summer 2020 to summer 2022. Neighborhood deprivation is associated with impaired mental health in youth during the COVID-19 pandemic. Children and adolescents' mental health and overall well-being should be addressed by health promotion measures to create a health-promoting living environment, including diverse neighborhoods. Future research should focus on uniform assessment methods and addressing additional neighborhood factors.

Does ethnic concentration buffer effects of neighborhood deprivation on early childhood growth?

BackgroundNeighborhood socioeconomic marginalization and racial residential segregation are associated with differential health outcomes in adulthood and pregnancy, but the intergenerational effects of these exposures on early childhood growth are underexplored. Our objective was to investigate racial and ethnic differences in the association between neighborhood deprivation and early childhood growth trajectories, with modification by neighborhood racial concentration. MethodsUsing longitudinal clinical data among 58,860 children receiving care in community-based clinics in the ADVANCE Clinical Data Research Network, we identified four early childhood (0–24 months) body mass index (BMI) trajectories using group-based trajectory modeling: Low, Catch-Up, Moderate, and High. In race- and ethnicity-stratified multinomial logistic regression analyses, trajectory group membership was modeled as a function of neighborhood deprivation, neighborhood racial concentration, neighborhood deprivation*racial concentration interactions, and confounders. ResultsGreater neighborhood deprivation was marginally associated with greater odds of Catch-Up trajectory for most racial and ethnic groups, with a null association observed among Assimilated Hispanic children. Conversely, neighborhood deprivation was not associated with Low trajectory for non-Hispanic Black or White children; however, in Less Assimilated Hispanic children, higher neighborhood deprivation was marginally associated with higher odds of Low trajectory, most strongly in neighborhoods with higher vs. lower Hispanic concentration. Associations between neighborhood deprivation and High trajectories varied substantially by race and ethnicity, ranging from inverse among Less Assimilated Hispanic children to a positive association among non-Hispanic White children that was attenuated in neighborhoods with higher White concentration. ConclusionGreater neighborhood deprivation was generally associated with greater or similar odds of each alternative growth trajectory, most consistently for non-Hispanic White and Black children. Associations were largely similar across levels of neighborhood racial concentration. Further research is needed to understand contextual or behavioral factors that contribute to the observed racial and ethnic differences in the association between neighborhood deprivation and early childhood growth.

Using diversity, equity and inclusion school practices to mitigate child health inequities in Canada

Abstract Background The burden of unhealthy lifestyle behaviours and mental disorders disproportionately affects children in deprived neighbourhoods. In Canada, school practices addressing diversity, equity and inclusion (DEI) are promoted to address such inequities. We aimed to assess whether DEI school practices can help mitigate the impact of neighbourhood deprivation on children’s lifestyle behaviours and mental health. Methods In 2023 we gathered survey data from 1497 grade 4-6 children (aged 9-12) in 22 elementary schools located in deprived neighbourhoods in Alberta, Canada. Children reported their diet, screen time, physical activity, and mental health. Principals reported on the implementation of DEI practices in schools (full vs. partial). School postal codes were used to derive tertiles of the Canadian Index of Multiple Deprivation, comprised of four dimensions that capture: 1) residential instability; 2) economic dependency; 3) ethno-cultural composition and 4) situational vulnerability of neighbourhoods. Results Overall, 45% of schools had fully implemented DEI practices. These schools were located in more deprived neighbourhoods for residential instability (55%), economic dependency (71%), ethno-cultural composition (60%), and situational vulnerability (64%). Children in more deprived neighbourhoods reported more sugar consumption, more screen time, and poorer mental health, compared to children in less deprived neighbourhoods. However, in those neighbourhoods where DEI practices were fully implemented, the adverse effects of neighbourhood deprivation were alleviated, whereby children reported less sugar consumption, less screen time, and better mental health. Conclusions The implementation of DEI school practices can help mitigate the adverse effects of neighbourhood deprivation on children’s physical and mental health, particularly in deprived neighbourhoods. Key messages • School practices targeting diversity, equity, and inclusion are more commonly implemented in schools located in deprived neighbourhoods. • Diversity, equity, and inclusion school practices mitigate the adverse effects of neighbourhood deprivation on children’s lifestyle behaviours and mental health.

How neighbourhood effects vary by achievement level

Abstract After long-standing calls for research into ‘for whom’ neighbourhood matters, the literature has recently gained traction, focussing on background characteristics such as gender, race, and socioeconomic background. However, there is still scarce and only indirect evidence on whether neighbourhood effects vary by children’s academic ability. In this paper, we combine the Neighbourhood Choice Model with quantile regressions to investigate whether neighbourhood effects vary by children’s academic proneness. Using Norwegian register data, we demonstrate heterogeneity in the effects of neighbourhood deprivation as a function of students’ proneness to academic achievement. Students with the very lowest and highest academic potential are the least affected by neighbourhood disadvantage, while those with below average—but not at the lowest end—are most strongly affected. Moreover, while girls are less affected than boys, and children from less educated and affluent families are more affected by neighbourhood disadvantage than their more privileged peers, the effects of these observed moderators are considerably smaller than the heterogeneity observed as a function of academic proneness. Overall, our use of quantile regressions opens up new venues for understanding ‘for whom’ neighbourhoods matter, with individual-level academic vulnerability and strengths being an influential source of neighbourhood effects variation.

B - 87 The Moderating Effects of Current Substance Use on the Relationship between Neighborhood Deprivation and Cognitive Abilities

Abstract Objective Numerous studies have illustrated the importance of social determinants of health (SDH) on neuropsychological outcomes (Zuelsdorff, 2020); however, what moderates this relationship is poorly understood. One factor that negatively affects neuropsychological outcomes is substance use (Volkow et al., 2016). This study, the first to our knowledge, examines the intersection between a composite measure of SDH, the Area Deprivation Index (ADI; Kind et al., 2018), and current substance use (CSU). We hypothesized that CSU would moderate SDH’s effect on neuropsychological test performance. Method This sample is 236 diverse adults (M age = 55; 64% female; 44% White) who completed a neuropsychological examination in an outpatient neuropsychology clinic between 2017–2023. The composite measure of SDH was the ADI (Kind et al., 2018), which uses 17 socioeconomic indicators. Test scores were converted to z-scores for six cognitive domains (processing speed, attention, executive functioning, language, visuospatial abilities, and memory) and a global cognitive function score. CSU was self-reported use of tobacco, alcohol, and marijuana. Regressions were used to test the hypothesized interaction. Results Results partially supported CSU’s moderation of ADI and cognition. CSU only moderated the relationship between ADI and memory functioning (b = −0.08,p = 0.008); the indirect association between ADI and memory ability was stronger for those who endorsed CSU, even after controlling for covariates. Conclusions Findings demonstrate the interaction between CSU and ADI in predicting memory abilities. Analyses suggest using substances compounds the detrimental effects of neighborhood deprivation on memory, independent of demographic factors. Such results underscore the importance of considering socioecological factors in neuropsychological evaluations and test development.

Environmental Impacts on Behavioral Health Interventions: The Moderating Effect of Neighborhood Deprivation on a Mobile Health Treatment for Depression

Relatively little scholarly attention has been given to incorporating geographic principles into investigations of behavioral health intervention efficacy—where, and why, a behavioral health intervention might be more effective in one place versus another. We address this research gap by leveraging data from a randomized controlled trial in a post-hoc analysis to investigate whether socioeconomic deprivation in the residential neighborhood moderates the efficacy of a text-message-delivered (mHealth) depression intervention targeted toward young adults. Ninety-seven participants were recruited from social media sources, randomly assigned to the treatment or control condition, and assessed for depression symptoms and related outcomes at baseline, one month, two months (immediately following treatment completion), and three months. We find that intervention effects for reducing depression symptoms were stronger among participants residing in neighborhoods with higher, as compared to lower, socioeconomic deprivation (β = −0.208, p = 0.013, 95 percent CI [−0.372, −0.044]). Similarly, stronger intervention effects for enhancing behavioral activation (β = 0.150, p = 0.028, 95 percent CI [0.016, 0.284]) and for reducing cognitive distortion (β = −0.476, p = 0.002, 95 percent CI [−0.777, −0.175]), malleable behaviors and thinking processes intended to lessen depression, were found for residents of higher deprivation neighborhoods. We speculate these results reflect an enhanced ability to intervene in processes of self-regulation among those living in higher deprivation neighborhoods, which might stem from the experience of chronic stress in such settings, thus resulting in greater receptivity to intervention components that reduce depressive symptoms. These findings could facilitate geographic targeting to enhance intervention efficacy and guide geographically informed health interventions tailored to specific environmental conditions.

Abstract 12275: Neighborhood Deprivation Predicts All-Cause and Cardiovascular Mortality in a Low-Income Population in the Southeastern United States

Background: Neighborhood disadvantage impacts individuals’ morbidity and mortality and contributes to health disparities, but prospective cohort data from individuals of low socioeconomic status (SES) are limited. Hypothesis: Greater neighborhood deprivation associates with higher all-cause and cardiovascular (CV) mortality beyond individual SES, lifestyle, and clinical factors in a multi-racial, low-income population. Methods: The Southern Community Cohort Study is a population-based cohort of mostly low SES individuals recruited from 12 southeastern US states between 2002-2009. Participant addresses were linked with a census tract-based neighborhood deprivation index (NDI) derived from neighborhood level income, education, employment, housing, and occupation data. Date and cause of death were ascertained via the National Death Index. Cox proportional hazard models were used to test associations between NDI and death adjusted for enrollment age, sex, self-reported race, education, income, insurance, smoking, physical activity, alcohol intake, diet, sleep duration, BMI, and diabetes, hypertension, depression, cancer, heart disease, and stroke. Results: Among 79,631 participants, median age was 51 years (25 th -75 th percentiles: 45-58), 69% were Black, and 60% were female. Over a median 13-year follow-up, 23,356 participants died, of which 7,214 (30.9%) were CV. With adjustment for age, sex, and race, per standard deviation (SD) increase in NDI was associated with a 19% increase in all-cause mortality (HR 1.19, 95% CI 1.18-1.21) and 16% increase in CV mortality (HR 1.16, 95% CI 1.13-1.19). Even with adjustment for individual SES, lifestyle, and clinical factors, NDI was associated with a 6% increased risk in all-cause mortality (HR per SD increase 1.06, 95% CI 1.03-1.08) and 8% increase in CV mortality (HR 1.08, 95% CI 1.05-1.11). NDI showed similar significant associations with all-cause and CV mortality in Black and White participants. Conclusion: Among low-income Americans, greater neighborhood deprivation associates with higher all-cause and CV mortality independent of individual SES, lifestyle, and clinical risk factors. More research is needed to examine factors underlying the health effects of neighborhood deprivation.

Material deprivation and the Brexit referendum: a spatial multilevel analysis of the interplay between individual and regional deprivation

Abstract In this study, we investigate the relationship between individual and neighbourhood deprivation and the decision to vote for Brexit in the 2016 referendum. Our analysis uses data from the UK Household Longitudinal Study and the English Index of Multiple Deprivation, and employs multilevel models to account for individual-level deprivation, neighbourhood deprivation, and larger-scale regional deprivation. We also examine the interaction between these scales. On average, we find that individual, neighbourhood, and wider area deprivation are associated with a higher likelihood of voting Leave. However, the effect of neighbourhood deprivation is heterogeneous and depends on the broader spatial context: living in deprived neighbourhoods (and to a lesser extent experiencing personal deprivation) has a stronger effect on voting behaviour in more affluent regions. Conversely, the effect of individual and neighbourhood deprivation is close to zero and statistically insignificant in more deprived areas of the country. These results suggest that social comparison processes of in-groups and out-groups operate within larger regional contexts. Our study thus highlights the role of individual and regional deprivation, but also their intersection, in shaping political attitudes and outcomes.

Neighbourhood deprivation and type 2 diabetes in patients with bipolar disorder: A nationwide follow-up study.

Patients with bipolar disorder have higher rates of type 2 diabetes (T2D) compared to the general population. Neighbourhood deprivation is associated with T2D and bipolar disorder. The aim of this study was to explore the potential effect of neighbourhood deprivation on incident T2D in patients with bipolar disorder. This nationwide open cohort study (1997-2018) included adults in Sweden ≥20years with bipolar disorder (90,780 patients) to examine the subsequent risk of T2D. The association between neighbourhood deprivation and T2D was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for individual-level sociodemographic factors and comorbidities. Neighbourhood deprivation was significantly associated with T2D in patients with bipolar disorder. The HRs were 1.61 (95% CI 1.40-1.86) for men and 1.83 (1.60-2.10) for women living in high deprivation neighbourhoods compared to those from low deprivation neighbourhoods. After adjustment, these results remained significant: 1.35 (1.17-1.56) in men and 1.39 (1.20-1.60) in women living in high deprivation neighbourhoods. The suggested graded association of higher incident T2D among patients with bipolar disorder, observed when levels of neighbourhood deprivation increased, raises important clinical and public health concerns. The results may help develop a contextual approach to prevention of T2D in patients with bipolar disorder that includes the neighbourhood environment.

Epigenetic age acceleration mediates the relationship between neighborhood deprivation and pain severity in adults with or at risk for knee osteoarthritis pain

An estimated 250 million people worldwide suffer from knee osteoarthritis (KOA), with older adults having greater risk. Like other age-related diseases, residents of high-deprivation neighborhoods experience worse KOA pain outcomes compared to their more affluent neighbors. The purpose of this study was to examine the relationship between neighborhood deprivation and pain severity in KOA and the influence of epigenetic age acceleration (EpAA) on that relationship. The sample of 128 participants was mostly female (60.9%), approximately half non-Hispanic Black (49.2%), and had a mean age of 58 years. Spearman bivariate correlations revealed that pain severity positively correlated with EpAA (ρ = 0.47, p ≤ 0.001) and neighborhood deprivation (ρ = 0.25, p = 0.004). We found a positive significant relationship between neighborhood deprivation and EpAA (ρ = 0.47, p ≤ 0.001). Results indicate a mediating relationship between neighborhood deprivation (predictor), EpAA (mediator), and pain severity (outcome variable). There was a significant indirect effect of neighborhood deprivation on pain severity through EpAA, as the mediator accounted for a moderate portion of the total effect, PM = 0.44. Epigenetic age acceleration may act as a mechanism through which neighborhood deprivation leads to worse KOA pain outcomes and may play a role in the well-documented relationship between the neighborhood of residence and age-related diseases.

Neighborhood deprivation, built environment, and overweight in adolescents in the city of Oslo

BackgroundEven though the social and built environment characteristics of neighborhoods have been studied as potential determinants of social inequalities in obesity among adults, fewer studies have focused on children. Our first aim was to investigate whether there were differences in the food and physical activity environments between different neighborhood deprivation levels in the city of Oslo. We also explored whether there was an association between the prevalence of overweight (including obesity) among adolescents and (i) neighborhood deprivation levels and (ii) food and physical activity environments of the neighborhoods they live in.MethodsWe conducted a food and physical activity environment mapping (using ArcGIS Pro) in all neighborhoods of Oslo, which were defined by administrative boundaries (sub-districts). The neighborhood deprivation score was calculated based on the percentage of households living in poverty, unemployment in the neighborhood, and residents with low education. A cross-sectional study including 802 seventh graders from 28 primary schools in Oslo residing in 75 out of 97 sub-districts in Oslo was also performed. MANCOVA and partial correlations were ran to compare the built environment distribution between different neighborhood deprivation levels, and multilevel logistic regression analyses were used to explore the effect of neighborhood deprivation and the food and physical activity environments on childhood overweight.ResultsWe found that deprived neighborhoods had greater availability of fast food restaurants and fewer indoor recreational facilities compared to low-deprived neighborhoods. Additionally, we observed that the residential neighborhoods of the adolescents with overweight had greater availability of grocery and convenience stores when compared to the residential neighborhoods of the adolescents without overweight. Adolescents living in neighborhoods with high deprivation had a two-fold higher odds (95% CI = 1.1–3.8) to have overweight compared to adolescents living in neighborhoods with low deprivation, regardless of participants’ ethnicity and parental education. However, the built environment did not determine the relationship between neighborhood deprivation and overweight in adolescents.ConclusionThe neighborhoods in Oslo with higher deprivation levels had more obesogenic characteristics than the low-deprived neighborhoods. Adolescents living in high-deprived neighborhoods were more likely to have overweight than their counterparts from low-deprived neighborhoods. Thus, preventive measures targeting adolescents from high-deprived neighborhoods should be put in place in order to reduce incidence of overweight.

Long-term association between neighbourhood socioeconomic deprivation in early childhood and perceived stress in early adulthood: a multilevel cohort study

BackgroundPrevious studies have shown that neighbourhood socioeconomic deprivation is related to mental health problems, with chronic stress responses as one possible biopsychological pathway; however, less is known about the possible...

Covid-19 restrictions: An opportunity to highlight the effect of neighbourhood deprivation on individuals’ health-related behaviours

RationaleNeighbourhood socio-economic deprivation is strongly related to health-risk behaviours, which are predictors of overall health and mortality. During the Covid-19 pandemic, individuals have been forced to spend more time within their residential areas, which might have had an effect on health-risk behaviours. ObjectiveWe assess the consequences of living in a more or less deprived neighbourhood during the pandemic on individual behavioural changes in four health-related outcomes: smoking, drinking, physical activity and healthy eating. We hypothesise that the pandemic and related lock-downs had negative effects on health-related behaviours, but that this negative effect had been stronger for people living in more deprived areas. We additionally explore sex and ethnicity as sources of heterogeneity in these effects. MethodsWe use data from four nationally representative cohort studies in England. We perform longitudinal individual and neighbourhood fixed effects estimations focusing on comparing the pre-pandemic period with the first lockdown (May 2020) period and up to one year after the outbreak of the pandemic (March 2021). ResultsDuring the first lockdown, as compared to pre-pandemic levels, on average, people smoked more, drunk more and did more physical activity. However, compared to people in less deprived neighbourhoods, people living in more deprived areas showed a smaller increase in their levels of physical activity, consumed less fruit and vegetables and increased the number of cigarettes smoked. We additionally find that the combined effect of Covid-19 and area deprivation varies significantly by both sex and ethnicity. ConclusionResults add to evidence on the impact of the Covid-19 pandemic and associated lockdowns on health-risk behaviours, highlighting the relative contribution of the neighbourhood environment and individual characteristics. We argue that reducing levels of neighbourhood deprivation may contribute to positively influence behaviours, especially for some sub-groups of the population, leading to a reduction of social inequalities in health.

PD21-04 THE IMPACT OF NEIGHBORHOOD DEPRIVATION AND RACE ON PROSTATE CANCER-SPECIFIC MORTALITY FOR WISCONSIN MEN

You have accessJournal of UrologyCME1 Apr 2023PD21-04 THE IMPACT OF NEIGHBORHOOD DEPRIVATION AND RACE ON PROSTATE CANCER-SPECIFIC MORTALITY FOR WISCONSIN MEN Ashanda R. Esdaille, Arighno Das, Glenn O. Allen, Daniel Shapiro, Kyle Richards, E. Jason Abel, David Jarrard, and Tudor Borza Ashanda R. EsdailleAshanda R. Esdaille More articles by this author , Arighno DasArighno Das More articles by this author , Glenn O. AllenGlenn O. Allen More articles by this author , Daniel ShapiroDaniel Shapiro More articles by this author , Kyle RichardsKyle Richards More articles by this author , E. Jason AbelE. Jason Abel More articles by this author , David JarrardDavid Jarrard More articles by this author , and Tudor BorzaTudor Borza More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003287.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Neighborhood deprivation contributes to worsened prostate cancer (PCa) outcomes. In Wisconsin, 54% of the population resides in the most deprived neighborhoods and the state ranks #1 in PCa incidence for Black men. In this study, we aimed to identify the association between neighborhood deprivation, race, and PCa-specific mortality (PCSM) for Wisconsin men. METHODS: Wisconsin Cancer Reporting System (WCRS) data were used to identify all men diagnosed with PCa between 1995-2010. Deprivation was measured by the Area of Deprivation Index (ADI) at the census block group level using the Neighborhood Atlas®, a validated composite measure which allows for rankings of neighborhoods by socioeconomic disadvantage based on income, education, employment, and housing quality. ADIs were categorized into quartiles. Differences in baseline demographic and clinicopathologic characteristics were determined using chi-square tests. Cox proportional hazards models were used to estimate the effect of neighborhood deprivation and race on PCSM, adjusted for age, clinical grade, stage, diagnosis year +/- treatment. RESULTS: 62,474 men with PCa were identified including 58,777 White, 2,706 Black, and 991 Other with a median follow up of 5.7 years (primary) and 9.6 years (sensitivity analyses). 33,558 men resided in the most deprived neighborhoods (Q3-Q4): 30,678 White vs 2,282 Black vs 591 Other. PCa-specific deaths were more prevalent in Q4 (12.5%) vs Q1 (9.6%), p<0.001. Men living in the most deprived neighborhoods had a slightly higher risk for PCSM (Q4: [aHR]=1.1 [95% CI 1.0-1.15], p=0.037). Deprived Black men were at a higher risk of PCSM vs deprived (Q4: HR=1.2 [95%CI 1.06-1.38], p=0.005) and least deprived White men (HR=1.3 [95% CI 1.15-1.52], p<0.001), but these were not statistically significant on adjusted and sensitivity analyses (p=0.13-0.88). The least deprived Black men (Q1: aHR=1.1 [95% CI 0.57-2.05], p=0.79) were no more likely to die from PCa than the least deprived White men. CONCLUSIONS: Race is implicated in worsened PCa outcomes, however, these findings support the association between neighborhood deprivation and PCSM as a potential mediator for race effects. These data support that neighborhood-level resources or interventions, such as access to care, are essential to improve or equalize PCa outcomes. Source of Funding: AUA/UCF Research Scholar Award Grant# 017-822959 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e591 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ashanda R. Esdaille More articles by this author Arighno Das More articles by this author Glenn O. Allen More articles by this author Daniel Shapiro More articles by this author Kyle Richards More articles by this author E. Jason Abel More articles by this author David Jarrard More articles by this author Tudor Borza More articles by this author Expand All Advertisement PDF downloadLoading ...

Investigating suicide related behaviours across sexual orientation and neighbourhood deprivation levels: A cohort study using linked health administrative data.

There have been no studies examining how neighbourhood deprivation modifies the effects of sexual minority status on suicide-related behaviours (SRB). Sexual minority individuals in deprived areas may face unique challenges and stressors that exacerbate their risk of SRB. This study aims to investigate the association between sexual minority status and clinical SRB, and examine whether the effect of neighbourhood deprivation differs across sexual orientation. A population-representative survey sample (169,090 respondents weighted to represent 8,778,120 individuals; overall participation rate 75%) was linked to administrative health data in Ontario, Canada to measure SRB-related events (emergency department visits, hospitalizations, and deaths) from 2007 to 2017. Neighbourhood-level deprivation was measured using the Ontario Marginalisation index measure of material deprivation at the dissemination area level. Discrete-time survival analysis models, stratified by sex, tested the effects of neighbourhood deprivation and sexual minority status, while controlling for individual-level covariates. Sexual minority men had 2.79 times higher odds of SRB compared to their heterosexual counterparts (95% CI 1.66 to 4.71), while sexual minority women had 2.14 times higher odds (95% CI 1.54 to 2.98). Additionally, neighbourhood deprivation was associated with higher odds of SRB: men in the most deprived neighbourhoods (Q5) had 2.01 times higher odds (95% CI 1.38 to 2.92) of SRB compared to those in the least deprived (Q1), while women had 1.75 times higher odds (95% CI 1.28 to 2.40). No significant interactions were observed between sexual minority status and neighbourhood deprivation levels. In both men and women, sexual minority status and neighbourhood deprivation are independent risk factors for SRB. Despite the lack of effect modification, sexual minorities living in the most deprived neighbourhoods have the highest chances of SRB. Future investigations should evaluate interventions and policies to improve sexual minority mental health and address neighbourhood deprivation.

Abstract A012: The effect of neighborhood deprivation on colorectal cancer patients in Louisiana: A multilevel study

Abstract Background Colorectal cancer incidence in Louisiana and the US exhibit profound racial and ethnic disparities, determined not only by individual-level predictors but also by neighborhood-level characteristics. Aggregate-level factors such as neighborhood deprivation level, rural/urban status, and accessibility to healthcare facilities are associated with geographic health disparities. This study examines the effect of area neighborhood deprivation on overall and early-onset (age &amp;lt; 50 years) CRC cancer incidence, stage at diagnosis, and survival. Methods From the Louisiana Tumor Registry we identified 18,903 eligible CRC cancer patients using ICD-O-3 codes C180-C189, C199, C209-C212, C218, and C260, with American Joint Committee on Cancer (AJCC) stage 0-IV between 2009 and 2018. The census tract (CT) level Area Deprivation Index (ADI) was calculated for the years 2010-2014 for all CTs where eligible patients reside. We convert the ADI to quantiles such that higher quantiles indicated more disadvantaged neighborhoods. Trend analysis of CRC cancer incidence by CT-level deprivation was conducted. Multilevel models were constructed to evaluate the influence of neighborhood deprivation on risk of advanced stage cancer diagnosis and death. Variables including sex, race/ethnicity, insurance, marital, smoking status, and primary subsite at the individual level and rural/urban status at the neighborhood level were adjusted. Results We observed a positive relationship between neighborhood deprivation and CRC cancer incidence, with an incidence rate of 38.91 (95% CI 37.32-40.50) cases per 100,000 for the least deprived areas and 57.29 (95% CI 55.20-59.37) cases per 100,000 among the CTs with the highest deprivation (P &amp;lt;.0001). For both males and females, CRC incidence increased linearly with higher deprivation, but males experienced stronger association than females. The incidence of early-onset CRC cancer ranged from 7.62 (95% CI 6.82-8.43) cases per 100,000 population in the least deprived quantile to 11.14 (95% CI 9.99-12.29) cases per 100,000 population in the most deprived ADI quantile (P &amp;lt; .0001). Multilevel model results estimate that the probability of advanced stage (AJCC stage II-IV) CRC cancer diagnosis increases as the deprivation index increases. Compared with patients in the least deprived group, living in the most deprived group was associated with the highest risk (OR: 1.31, 95% CI 1.14-1.52). Although the adjusted survival is similar across deprivation quantiles (HR = 1), an advanced stage of diagnosis significantly increases the overall and cause-specific risk of death. Conclusion Overall and early-onset CRC cancer incidence increases in areas with higher neighborhood deprivation level. Greater neighborhood derivation is associated with more advanced stage (AJCC II-IV) CRC cancer diagnosis. Acknowledgment Supported by NIH/NCI 1R01CA259420. Citation Format: Tingting Li, Ariane L. Rung, Madhav KC, Mei-Chin Hsieh, Laura S. Rozek, Edward S. Peters. The effect of neighborhood deprivation on colorectal cancer patients in Louisiana: A multilevel study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A012.

Neighborhood deprivation and preeclampsia or eclampsia in high-risk pregnancy

Area Deprivation Index (ADI) is a composite score of socioeconomic factors created to study the effect of neighborhood deprivation on various health outcomes. Preeclampsia is a leading cause of adverse maternal and neonatal outcomes, yet the relationship between neighborhood deprivation and preeclampsia remains understudied. We aimed to quantify the association between ADI and preeclampsia or eclampsia.

Neighborhood deprivation and coronary heart disease in patients with bipolar disorder

The aim was to study the potential effect of neighborhood deprivation on incident and fatal coronary heart disease (CHD) in patients with bipolar disorder. This was a nationwide cohort study which included all adults aged 30 years or older with bipolar disorder (n = 61,114) in Sweden (1997–2017). The association between neighborhood deprivation and the outcomes was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (CIs). Patients with bipolar disorder living in neighborhoods with high or moderate levels of deprivation were compared with those living in neighborhoods with low deprivation scores. There was an association between level of neighborhood deprivation and incident and fatal CHD among patients with bipolar disorder. The HRs were 1.24 (95% CI 1.07–1.44) for men and 1.31 (1.13–1.51) for women for incident CHD among patients with bipolar disorder living in high deprivation neighborhoods compared to those from low deprivation neighborhoods, after adjustments for potential confounders. The corresponding HR for fatal CHD were 1.35 (1.22–1.49) in men and 1.30 (1.19–1.41) in women living in high deprivation neighborhoods. Increased incident and fatal CHD among patients with bipolar disorder living in deprived neighborhoods raises important clinical and public health concerns.

Associations among Household and Neighborhood Socioeconomic Disadvantages, Resting-state Frontoamygdala Connectivity, and Internalizing Symptoms in Youth.

Exposure to socioeconomic disadvantages (SED) can have negative impacts on mental health, yet SED are a multifaceted construct and the precise processes by which SED confer deleterious effects are less clear. Using a large and diverse sample of preadolescents (ages 9-10 years at baseline, n = 4038, 49% female) from the Adolescent Brain Cognitive Development Study, we examined associations among SED at both household (i.e., income-needs and material hardship) and neighborhood (i.e., area deprivation and neighborhood unsafety) levels, frontoamygdala resting-state functional connectivity, and internalizing symptoms at baseline and 1-year follow-up. SED were positively associated with internalizing symptoms at baseline and indirectly predicted symptoms 1 year later through elevated symptoms at baseline. At the household level, youth in households characterized by higher disadvantage (i.e., lower income-to-needs ratio) exhibited more strongly negative frontoamygdala coupling, particularly between the bilateral amygdala and medial OFC (mOFC) regions within the frontoparietal network. Although more strongly positive amygdala-mOFC coupling was associated with higher levels of internalizing symptoms at baseline and 1-year follow-up, it did not mediate the association between income-to-needs ratio and internalizing symptoms. However, at the neighborhood level, amygdala-mOFC functional coupling moderated the effect of neighborhood deprivation on internalizing symptoms. Specifically, higher neighborhood deprivation was associated with higher internalizing symptoms for youth with more strongly positive connectivity, but not for youth with more strongly negative connectivity, suggesting a potential buffering effect. Findings highlight the importance of capturing multilevel socioecological contexts in which youth develop to identify youth who are most likely to benefit from early interventions.

Neighborhood deprivation and severe maternal morbidity in a medicaid-Insured population in Georgia

Background Despite growing acceptance of the role of context in shaping perinatal risk, data on how neighborhood factors may identify high-risk obstetric patients is limited. In this study, we evaluated the effect of neighborhood deprivation and neighborhood racial composition on severe maternal morbidity (SMM) among persons delivered in a large public health system in Atlanta, Georgia. Methods We conducted a population cohort study using electronic medical record data on all deliveries at Grady Memorial Hospital during 2011–2020. Using residential zip codes, we calculated neighborhood deprivation index based on data from the US Census. We used log-binomial regression with generalized estimating equations to estimate crude and adjusted relative risks (aRR) and 95% confidence intervals (CI) for the association between tertile of neighborhood deprivation and SMM, adjusting for demographic, clinical, and neighborhood-level (racial composition, food desert, and transit access) covariates. Results Among 25,257 deliveries, 6.2% (1566) experienced SMM. Approximately 24.0%, 32.0%, and 44.0% of women lived in the lowest, middle, and highest tertile of neighborhood deprivation, respectively and 64.9% lived in a neighborhood with majority non-Hispanic Black residents. After adjustment, there was no association between neighborhood deprivation and SMM (aRR: 1.0 (0.8, 1.1)) or residence in a majority Black neighborhood and SMM (aRR:1.0 (0.9, 1.2)). Conclusion In this safety-net hospital, residence in a high deprivation or majority Black neighborhood did not predict SMM at or following delivery. Individual-level social determinants may better explain variation in risk, particularly in high-burden populations.