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

Abstract #105313

Sanae Inagami, MD, MPH, General Internal Medicine/Health Services Research, West Los Angeles VA/UCLA, Box 111G, 11301 Wilshire Blvd, Los Angeles, CA 90073, 310-478-3711, sinagami@ucla.edu, Deborah A. Cohen, MD, MPH, Health, RAND Corporation, 1700 Main Street, Santa Monica, CA 90405, and Brian K. Finch, PhD, RAND Health, RAND, 1700 Main Street, Santa Monica, CA 90405.

Background: Researchers have begun to examine residential neighborhood level predictors in order to explain the mechanisms that lie behind the geographic distribution of disease. Most neighborhood predictors have shown weak and inconsistent results. Exposure of individuals to different environments may influence the benefits or the risks associated with the individual's residential neighborhood. To determine if other exposures modify residential neighborhood effects we examined the effect of other environments that figure in daily routines on adult self-reported health.

Methods: We linked the 2000 US Census data with the Los Angeles Family and Neighborhood Study database consisting of 3407 adults sampled from neighborhoods in LA County. Neighborhood characteristics of census tracts where respondents lived, worked, obtained health care, shopped, and worshipped were obtained from the 2000 US Census. Multilevel linear regression models were used to estimate associations between self-reported health and non-residential neighborhood exposures after adjustment for individual-level factors and exposure to residential neighborhoods.

Results: Living in deprived neighborhoods was associated with worse self-reported health; models including exposure to non-residential neighborhoods increased this association. The greater the exposure to less deprived non-residential neighborhoods, the greater the magnitude in improved self-reported health.

Conclusions: People who spent time in less deprived neighborhoods had better self-reported health compared to those who stayed in deprived neighborhoods. Inclusion of non-residential neighborhood exposure in the model increased the predictive validity of residential neighborhood exposure, indicating its role as a negative confounder. Non-residential neighborhood exposure may explain why studies have not found robust associations between residential neighborhoods and health.

Learning Objectives:

• At the conclusion of the session,participants should be able to recognize some of the weaknesses of current research in residential neighborhoods and its association with health outcomes. When faced with similar problems, they may want to apply the methods we have developed or to construct similar methods in order to assess the influence of other environments on an individual's health.

Keywords: Epidemiology, Geographic Information Systems

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.

Recorded presentation