Neighborhood socioeconomic deprivation and mortality: NIH-AARP diet and health study.
OBJECTIVE
Residing in deprived areas may increase risk of mortality beyond that explained by a person's own SES-related factors and lifestyle. The aim of this study was to examine the relation between neighborhood socioeconomic deprivation and all-cause, cancer- and cardiovascular disease (CVD)-specific mortality for men and women after accounting for education and other important person-level risk factors.


METHODS
In the longitudinal NIH-AARP Study, we analyzed data from healthy participants, ages 50-71 years at study baseline (1995-1996). Deaths (n = 33831) were identified through December 2005. Information on census tracts was obtained from the 2000 US Census. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for quintiles of neighborhood deprivation.


RESULTS
Participants in the highest quintile of deprivation had elevated risks for overall mortality (HR(men) = 1.17, 95% CI: 1.10, 1.24; HR(women) = 1.13, 95% CI: 1.05, 1.22) and marginally increased risk for cancer deaths (HR(men) = 1.09, 95% CI: 1.00, 1.20; HR(women) = 1.09, 95% CI: 0.99, 1.22). CVD mortality associations appeared stronger in men (HR = 1.33, 95% CI: 1.19, 1.49) than women (HR = 1.18, 95% CI: 1.01, 1.38). There was no evidence of an effect modification by education.


CONCLUSIONS
Higher neighborhood deprivation was associated with modest increases in all-cause, cancer- and CVD-mortality after accounting for many established risk factors.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA. Jacqueline.major@nih.gov
Jacqueline M
JM
Major
Chyke A
CA
Doubeni
Neal D
ND
Freedman
Yikyung
Y
Park
Min
M
Lian
Albert R
AR
Hollenbeck
Arthur
A
Schatzkin
Barry I
BI
Graubard
Rashmi
R
Sinha
D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D015999:Multivariate Analysis; D009316:National Institutes of Health (U.S.); D009369:Neoplasms / Q000401:mortality*; D015596:Nutrition Assessment; D025341:Principal Component Analysis; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D018570:Risk Assessment / Q000706:statistics & numerical data; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology