Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103865

Marilyn A. Winkleby, PhD, MPH, Stanford Prevention Research Center, Stanford School of Medicine, 211 Quarry Road, Room 229, Stanford, CA 94305-5705, 650-723-7055, winkleby@stanford.edu, David K. Ahn, PhD, Stanford Prevention Research Center, Stanford University School of Medicine, 211 Quarry Road, N229, Stanford, CA 94305-5705, and Catherine Cubbin, PhD, Department of Family and Community Medicine, University of California, San Francisco, 500 Parnassus Avenue, MU-3 East, Box 0900, San Francisco, CA 94143-0900.

Objectives: To examine whether the effect of neighborhood-level socioeconomic status (SES) on mortality varied by individual-level SES, and whether any differences were explained by baseline characteristics and/or proximity to essential goods and services. Methods: Population-based, prospective mortality study of 4476 women and 3721 men, aged 25-74 at baseline, from 4 California cities, living in 82 neighborhoods. Women and men were surveyed and medically examined between 1979 and 1990, and followed until 12/31/2002 (1,148 deaths, mean follow-up time, 17.4 years). Neighborhood SES, defined by five census variables, was divided into three levels. Individual SES, defined by a composite of household income and educational level, was divided into tertiles. Results: Death rates for women and men with moderate and high SES showed no clear pattern by level of neighborhood SES. In contrast, death rates for women and men with low SES increased with each increasing level of neighborhood SES. Death rates for low SES women in low SES neighborhoods were 1128 per 100,000 person years, increased to 1323 in moderate SES neighborhoods, and further increased to 1907 in high SES neighborhoods; rates for low SES men were 1590, 1646, and 1928 respectively in low, moderate and high SES neighborhoods. These findings were not explained by baseline differences in individual-level sociodemographic characteristics, health behaviors, risk factors, health status, or causes of death, but were partially explained by proximity to neighborhood goods and services. Conclusion: High SES neighborhoods appear to have a detrimental effect on risk of dying for low SES women and men.

Learning Objectives:

• Educate participants about the influence of neighborhood social environments on mortality.
• Describe measures of neighborhood social environments, available from the U.S. census and archival data sources.
• Identify implications for public health policy and practice.

Keywords: Environment, Epidemiology

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.