There's an excellent new paper published in PLoS One authored by Jacqueline M. Major et al. entitled Neighborhood Socioeconomic Deprivation and Mortality: NIH-AARP Diet and Health Study.
Here is the Abstract:
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.
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.
Participants in the highest quintile of deprivation had elevated risks for overall mortality (HRmen = 1.17, 95% CI: 1.10, 1.24; HRwomen = 1.13, 95% CI: 1.05, 1.22) and marginally increased risk for cancer deaths (HRmen = 1.09, 95% CI: 1.00, 1.20; HRwomen = 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.
Higher neighborhood deprivation was associated with modest increases in all-cause, cancer- and CVD-mortality after accounting for many established risk factors.
This is a particularly interesting study because of its efforts to control for "person-specific risk factors" in the hopes of evaluating the extent to which simply living in a deprived neighborhood can produce deleterious effects on health. The fact that the investigators found statistically significant increases between such deprivation and all-cause, cancer, and CVD mortality is both unsurprising and significant given the increasing evidence in the SDOH literature that "place matters." Here the authors posit some mechanisms for the relationship:
"Potential mechanisms by which neighborhood deprivation may influence mortality include physical environment/environmental exposures and social norms. In particular, areas with higher deprivation may have issues such as limited availability of or access to healthy foods and health care, higher environmental pollution, and lack of social networks that might also impact mortality risk independently of the characteristics of the people living in those areas."
The article is recommended.
(h/t SDOH listserv)