title: Health status, neighborhood socioeconomic context, and premature mortality in the United States: The National Institutes of Health-AARP Diet and Health Study.
abstract: OBJECTIVE
  We examined whether the risk of premature mortality associated with living in socioeconomically deprived neighborhoods varies according to the health status of individuals.
  
  
  METHODS
  Community-dwelling adults (n = 566,402; age = 50-71 years) in 6 US states and 2 metropolitan areas participated in the ongoing prospective National Institutes of Health-AARP Diet and Health Study, which began in 1995. We used baseline data for 565,679 participants on health behaviors, self-rated health status, and medical history, collected by mailed questionnaires. Participants were linked to 2000 census data for an index of census tract socioeconomic deprivation. The main outcome was all-cause mortality ascertained through 2006.
  
  
  RESULTS
  In adjusted survival analyses of persons in good-to-excellent health at baseline, risk of mortality increased with increasing levels of census tract socioeconomic deprivation. Neighborhood socioeconomic mortality disparities among persons in fair-to-poor health were not statistically significant after adjustment for demographic characteristics, educational achievement, lifestyle, and medical conditions.
  
  
  CONCLUSIONS
  Neighborhood socioeconomic inequalities lead to large disparities in risk of premature mortality among healthy US adults but not among those in poor health.
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, 01655, USA. chyke.doubeni@umassmed.edu
authors.forename: Chyke A
authors.initials: CA
authors.lastname: Doubeni
authors.forename: Mario
authors.initials: M
authors.lastname: Schootman
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Major
authors.forename: Rosalie A Torres
authors.initials: RA
authors.lastname: Stone
authors.forename: Adeyinka O
authors.initials: AO
authors.lastname: Laiyemo
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Min
authors.initials: M
authors.lastname: Lian
authors.forename: Lynne
authors.initials: L
authors.lastname: Messer
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.forename: Rashmi
authors.initials: R
authors.lastname: Sinha
authors.forename: Albert R
authors.initials: AR
authors.lastname: Hollenbeck
authors.forename: Arthur
authors.initials: A
authors.lastname: Schatzkin
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D004034:Diet Surveys; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature / Q000639:trends*; D009316:National Institutes of Health (U.S.); D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology