title: Why is poverty unhealthy? Social and physical mediators.
abstract: Socioeconomic status is associated with mortality, yet does not fully explain health disparities. This study analyzed data from the Project on Human Development in Chicago Neighborhoods (PHDCN), in the USA, to identify neighborhood-level factors associated with premature mortality. 1990 US Census data and mortality data from Chicago were merged with data from PHDCN, a study of 8782 residents in 343 Chicago neighborhoods. We performed a multivariate analysis to determine the association between premature mortality and concentrated disadvantage, residential stability, immigrant concentration, "collective efficacy" (a measure of willingness to help out for the common good), and "broken windows" (boarded up stores and homes, litter, and graffiti). Both collective efficacy and broken windows appeared to mediate the effect of concentrated disadvantage on all-cause premature mortality and mortality from cardiovascular disease and homicide, but there was also an interaction between broken windows and collective efficacy. Non-income characteristics associated with poverty should be further investigated. Interventions to determine whether these factors are causally related to health are needed.
authors.affiliation: RAND Corporation, 1700 Main Street, Santa Monica, CA 2138, USA. dcohen@rand.org
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Cohen
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Farley
authors.forename: Karen
authors.initials: K
authors.lastname: Mason
mesh_terms: D000293:Adolescent; D000328:Adult; D019352:Censuses; D002641:Chicago / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data*; D011204:Poverty Areas; D012111:Residence Characteristics / Q000145:classification* / Q000706:statistics & numerical data; D012940:Social Problems; D012944:Social Support; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data*