title: Neighbourhood socioeconomic status and biological 'wear and tear' in a nationally representative sample of US adults.
abstract: OBJECTIVE
  To assess whether neighbourhood socioeconomic status (NSES) is independently associated with disparities in biological 'wear and tear' measured by allostatic load in a nationally representative sample of US adults.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Population-based US survey, the Third National Health and Nutrition Examination Survey (NHANES III), merged with US census data describing respondents' neighbourhoods.
  
  
  METHODS
  13,184 adults from 83 counties and 1805 census tracts who completed NHANES III interviews and medical examinations and whose residential addresses could be reliably geocoded to census tracts.
  
  
  METHODS
  A summary measure of biological risk, incorporating nine biomarkers that together represent allostatic load across metabolic, cardiovascular and inflammatory subindices.
  
  
  RESULTS
  Being male, older, having lower income, less education, being Mexican-American and being both black and female were all independently associated with a worse allostatic load. After adjusting for these characteristics, living in a lower NSES was associated with a worse allostatic load (coefficient -0.46; CI -0.079 to -0.012). The relationship between NSES and allostatic load did not vary significantly by gender or race/ethnicity.
  
  
  CONCLUSIONS
  Living in a lower NSES in the USA is associated with significantly greater biological wear and tear as measured by the allostatic load, and this relationship is independent of individual SES characteristics. Our findings show that where one lives is independently associated with allostatic load, thereby suggesting that policies that improve NSES may also yield health returns.
authors.affiliation: RAND Corporation, 1776 Main Street, P O Box 2138, Santa Monica, CA 90407-2138, USA. chloe@rand.org
authors.forename: Chloe E
authors.initials: CE
authors.lastname: Bird
authors.forename: Teresa
authors.initials: T
authors.lastname: Seeman
authors.forename: José J
authors.initials: JJ
authors.lastname: Escarce
authors.forename: Ricardo
authors.initials: R
authors.lastname: Basurto-Dávila
authors.forename: Brian K
authors.initials: BK
authors.lastname: Finch
authors.forename: Tamara
authors.initials: T
authors.lastname: Dubowitz
authors.forename: Melonie
authors.initials: M
authors.lastname: Heron
authors.forename: Lauren
authors.initials: L
authors.lastname: Hale
authors.forename: Sharon Stein
authors.initials: SS
authors.lastname: Merkin
authors.forename: Margaret
authors.initials: M
authors.lastname: Weden
authors.forename: Nicole
authors.initials: N
authors.lastname: Lurie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052636:Allostasis / Q000502:physiology*; D044383:Black People / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000208:ethnology / Q000523:psychology; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006305:Health Status Indicators; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D016014:Linear Models; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D009749:Nutrition Surveys; D012111:Residence Characteristics; D012737:Sex Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American