Dataset Information

A prospective investigation of neighborhood socioeconomic deprivation and self-rated health in a large US cohort.

ABSTRACT: BACKGROUND:Neighborhood characteristics play a critical role in health. Self-rated health (SRH) is an important indicator of quality of life and a strong predictor of premature death. Prospective study on neighborhood deprivation and SRH is limited. METHODS:We examined neighborhood socioeconomic deprivation with reporting fair/poor SRH at follow-up (2004-2006) in 249,265 men and women (age 50-71) who reported SRH as good or better at baseline (1995-1996) in the NIH-AARP Health and Diet Study. Baseline addresses were geocoded and linked to 2000 Census. Census tract level variables were used to generate a socioeconomic deprivation index by principle component analysis. RESULTS:Residents of more deprived neighborhoods had a higher risk of developing poor/fair SRH at follow-up, even after adjusting for individual-level factors (Odds ratio (95% confidence interval) Q5 vs Q1: 1.26 (1.20, 1.32), p-trend: <0.0001). The results were largely consistent across subgroups with different demographics, health behaviors, and disease conditions and after excluding participants who moved away from their baseline address. CONCLUSION:Neighborhood disadvantage predicts SRH over 10 years.

SUBMITTER: Xiao Q

PROVIDER: S-EPMC5425289 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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A prospective investigation of neighborhood socioeconomic deprivation and self-rated health in a large US cohort.

Xiao Qian Q Berrigan David D Matthews Charles E CE

Health & place 20170206

<h4>Background</h4>Neighborhood characteristics play a critical role in health. Self-rated health (SRH) is an important indicator of quality of life and a strong predictor of premature death. Prospective study on neighborhood deprivation and SRH is limited.<h4>Methods</h4>We examined neighborhood socioeconomic deprivation with reporting fair/poor SRH at follow-up (2004-2006) in 249,265 men and women (age 50-71) who reported SRH as good or better at baseline (1995-1996) in the NIH-AARP Health and ...[more]

PMID: 28183012

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Project description:Rational & objectiveNeighborhood socioeconomic status (SES) and health insurance status may be important upstream social determinants of chronic kidney disease (CKD), but their relationship remains unclear. The aim of this study was to determine whether neighborhood SES and individual-level health insurance status were independently associated with CKD prevalence.Study designObservational study using electronic health records (EHRs).Setting & participantsEHRs of patients (n = 185,269) seen at a health care system in the 7-county Minneapolis/St Paul area (2017-2018).ExposuresCensus tract neighborhood SES measures (median value of owner-occupied housing units [wealth], percentage of residents aged >25 years with bachelor's degree or higher [education]) and individual-level health insurance status (aged <65 years: Medicaid vs other insurance; ≥65 years: Medicare vs Medicare and supplemental insurance plan) were obtained from the American Community Survey and EHR data. Neighborhood SES was operationalized into quartiles, comparing low (first quartile) versus high (fourth quartile) neighborhood SES.OutcomesCKD prevalence: estimated glomerular filtration rate < 60 mL/min/1.73 m2 or proteinuria.Analytic approachMultilevel Poisson regression with robust error variance with a random intercept at the census-tract level, adjusted for demographic and clinical covariates, was used to estimate the association between neighborhood SES, insurance, and CKD.ResultsNeighborhood SES and insurance were independently associated with CKD prevalence. In covariate-adjusted models, patients living in low versus high neighborhood SES had a higher CKD prevalence among both younger and older patients. For example, the prevalence ratios of CKD in low versus high neighborhood SES as defined by education among patients younger than 65 and 65 years and older were 1.11 (95% CI, 1.05-1.18) and 1.08 (95% CI, 1.04-1.12), respectively. Patients younger than 65 years receiving Medicaid had higher CKD prevalence versus those with other insurance (1.51 [95% CI, 1.43-1.6]). For patients 65 years and older, insurance was not associated with prevalence of CKD in the fully adjusted model.LimitationsOne health care system and selection bias.ConclusionsLiving in low neighborhood SES as defined by wealth and education and having Medicaid for patients younger than 65 years were associated with higher CKD prevalence.

Dataset Information

A prospective investigation of neighborhood socioeconomic deprivation and self-rated health in a large US cohort.

Publications

A prospective investigation of neighborhood socioeconomic deprivation and self-rated health in a large US cohort.

Similar Datasets

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