226385 Geographic variations in heart disease mortality and socioeconomic status (SES) in Davidson County zip codes, Tennessee: Do differences in geographic levels of analysis matter?

Monday, November 8, 2010 : 3:00 PM - 3:15 PM

Green A. Ekadi, PhD, MS , School of Graduate Studies and Research, Meharry Medical College, Nashville, TN
Amy Hampton, BS, MSPH , Texas Health Resources, Community Health Outreach, Arlington, TN
Maria del Pilar Aguinaga, PhD, DLM (ASCP) , Department of Obstetrics and Gynecology/Sickle Cell Center, Meharry Medical College, Nashville
Robert S. Levine, MD , Department of Family & Community Medicine, Meharry Medical College, Nashville, TN
Background: There is sufficient research evidence of the inverse relationship between socioeconomic status and health outcomes. The CDC estimates that behavioral, socioeconomic and physical environmental conditions account for about 90% of total mortality in the US, with only 10% attributable to the lack of access. Study after study has confirmed that mortality and morbidity rates increase as socioeconomic status (SES) decreases, some suggesting a “gradient effect” across US communities, a phenomenon whereby each socioeconomic group's health status is better than the group immediately below it. Problem and Significance: These findings are based on data from epidemiological surveillance systems in place at local and state health departments. Population systems epidemiology has shown that micro-level analysis promotes a clearer understanding that socioeconomically deprived neighborhoods have poorer health, on average, than affluent neighborhoods. This discipline argues that the arrangement of environmental elements such as the pattern of neighborhood experiences and exposures influences the trajectories of individual and population health. Using micro-level data to confirm relationships that have been established with macro–level data is, therefore, significant. Objective: To explore whether zip-code level variations in SES in Davidson county can explain zip-code level variations in heart disease mortality in the county and whether the observed inverse relationship at macro-level data can be confirmed with zip-code data. Methods: Using heart disease mortality data from the Metropolitan Public Health Department and SES data from the US 2000 census, the study will construct a Townsend index of socioeconomic deprivation to investigate this relationship.

Learning Areas:
Chronic disease management and prevention
Public health or related research

Learning Objectives:
· To describe the use of small area data for health research and analysis · To discuss whether small area data can confirm the inverse relationship between health and SES already observed with large area data

Keywords: Minority Health, Community Health Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a professor in a graduate program in public health and my research is in the socioeconomic determinants of health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.