Background: Socioeconomic status (SES) is one of the strongest predictors of mortality. Although the largest number of low SES adults in the US are white, no study has examined the influence of individual and neighborhood measures of SES on premature mortality within a national sample of the white population. Methods: We analyzed data for 169,519 white men and 180,437 white women from the National Health Interview Survey (1987-1994), linked with 1990 census tract data and mortality data through 1995. We examined whether there was a gradient between individual SES (education, income, occupational/employment status) and neighborhood SES (proportion poor) with all-cause mortality and the five leading causes of death for men and women aged 25-64, an age range that reflects premature mortality. Results: Each individual and neighborhood measure of SES was associated with all-cause mortality and the five leading causes of death, and each association appeared as a gradient. When individual and neighborhood measures of SES were considered together, death rates for lower SES adults who lived in lower SES neighborhoods were over three times higher than death rates for higher SES adults who lived in higher SES neighborhoods (1224 versus 360 deaths/100,000 person-years for men; 698 versus 219 deaths/100,000 person-years for women). The gradient between neighborhood SES and all-cause mortality remained significant after controlling for individual SES (p<0.0001 for men, p<0.008 for women). Conclusion: Low SES white women and men living in poor neighborhoods experience a tremendous burden of premature mortality, a finding often overlooked by current studies and public policy.
Learning Objectives: 1. Recognize the tremendous burden of premature mortality experienced by low SES white women and men living in poor neighborhoods. 2. Assess the influence of neighborhood poverty on premature mortality among white women and men.
Keywords: Social Inequalities, Mortality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.