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APHA Scientific Session and Event Listing

Recorded presentation

Karl Eschbach, PhD, Internal Medicine/Geriatrics 0460, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0460, 409-747-3516, kaeschba@utmb.edu and Zhao Wu, PhD, Obstetrics and Gynecology 0587, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0587.

Purpose: To investigate ethnic differences in the relationship between the neighborhood economic gradient and other contextual determinants of all cause and socio-behavioral causes of death for younger adult women. Outcomes include mortality from homicide, suicide, substance use, unintentional accidents, HIV, and other infections. We investigate ecological associations of mortality with contextual variables including poverty, family disruption, racial/ethnic isolation, immigrant concentration, and area economic inequality. Data: Vital records of deaths of women ages 15 to 49 years in California and Texas for 1999-2001. Counts are linked to population denominators, economic and social structural characteristics for census tract of residence at death. We use Poisson and related regression models to investigate contextual correlates of differences in mortality for African American, Latina, and White women. Results: The tract poverty rate is significantly associated with higher mortality for all social-behavioral causes for non-Latina white (O.R.=1.016) and African American women (O.R.=1.028), but much less so for Latinas (O.R.=1.004). By contrast, percent children living in single-parent families is associated with sharply increased socio-behavioral mortality for non-Latina whites (O.R.=3.21) and Latinas (O.R.=2.29), but not African Americans (O.R.=0.75). Similar patterns are found for all-cause mortality and most specific social-behavioral causes except suicide. Significance: The effect of the economic gradient and other social structural determinants on the mortality rates of younger women varies between ethnic populations. For Hispanic women, the economic gradient is weaker than for other groups, while for African American women, effects of tract family structures are less marked than for either non-Hispanic whites or Hispanics.

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

• Describe all cause and social-behavioral mortality patterns for younger African American, Latina, and non-Hispanic white women in Texas and California.
• Identify primary neighborhood contextual risks for socio-behavioral mortality for younger women.
• Compare the determinants of socio-behavioral mortality for women from different racial/ethnic populations.

Keywords: Mortality, Health Disparities

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation