The 130th Annual Meeting of APHA

5100.0: Wednesday, November 13, 2002 - 12:45 PM

Abstract #40119

Contribution of social context to years of life lost to heart disease in Texas

Luisa Franzini, PhD, University of Texas School of Public Health, 1200 Herman Pressler, Houston, TX 77030, 713 500 9487, and William Spears, PhD, San Antonio satellite, University of Texas School of Public Health, 7703 Floyd Curl Drive, San Antonio, TX 78284.

This study investigates the contributions of individual socioeconomic factors (sex, race, and education) and social context at the neighborhood level (wealth and racial/ethnic segregation), and the county level (social inequality, human and social capital, economic and demographic characteristics) on premature cardiovascular mortality. Death certificate information was obtained for all those who died of heart disease in Texas in 1991. Deaths were geocoded to obtain block, tract, and county social context from the census. Multilevel hierarchical models quantified the contributions of individual characteristics and block, tract, and county social context on years of potential life lost to heart disease. Separate models were estimated by sex and by race/ethnicity. Being female, having more education, and residing in an area with higher median house value were associated with less premature mortality. Although blacks and Hispanics lost more years of life to heart disease than whites, blacks and Hispanics living in tracts with higher own racial/ethnic group density lost fewer years of life than their peers living in less segregated tracts. At the county level, the association with premature mortality was negative for percent homeowners and positive for crime. Tract and county level variances were statistically significant indicating the appropriateness of using multilevel models. Results for blacks and Hispanics varied somewhat. Social context at the block, tract, and county level played an important role, though a smaller role than individual factors, in explaining years of life lost to heart disease. Health policies should incorporate these findings by developing socially grounded interventions for heart disease.

Learning Objectives: At the conclusion of the session, the participant will be able to

Keywords: Heart Disease, Social Inequalities

Presenting author's disclosure statement:
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.

The Practice of Epidemiology in the Public Health Sector: Methods

The 130th Annual Meeting of APHA