The Influence of individual and neighborhood socioeconomic status on mortality among black, Mexican-American, and white women and men in the United States
Abstract overview:
This study aims to examine the role of a neighborhood’s environment on its residents. More commonly, past studies have focused on the relationship between an individual’s socioeconomic status and overall health, but this study, which uses a nationally representative sample that includes the three largest racial/ethnic groups of women and men in the United States, (Mexican-American, African-American, and white), sheds light on how neighborhood environments can ultimately affect residents’ mortality rates. The study examines mortality rates by both individual socioeconomic status (SES) – measured by an individuals’ income, education, and occupational/employment status – and neighborhood SES – measured by the index of neighborhood income/wealth, educational attainment, occupational/employment status. This study also recognizes that men and women have different health profiles and risk factors and that the various ethnic groups followed in this study live in different neighborhoods.
After taking individual SES into account, the study found that neighborhoods do, indeed, affect residents’ mortality rates. Moreover, the study concluded that mortality rates, for the most part, would drop substantially if all men and women, regardless of ethnicity and/or socioeconomic status, lived in the highest SES neighborhoods.
The study has two major findings: (1) Individual socioeconomic status is a major factor for a person’s overall health, but the qualities of the community in which someone lives also affects his/her health, even if you take into account their individual SES. (2) Deaths for each gender and ethnic group studied would be reduced by about 20 percent if everyone had the same death rates of those living in the highest SES neighborhoods (top third). Black women and men would benefit even more.
The study finds that, in general, living in a low SES neighborhood is associated with increased risk of mortality, regardless of a person’s individual SES. Mortality rates for all six gender and ethnic groups were two to four times higher for those with the lowest incomes who lived in the lowest SES neighborhoods compared with those with the highest incomes who lived in the highest SES neighborhoods.
This study concludes that deaths would hypothetically be reduced by about 20 percent for each subgroup, with the exception of Mexican-American women, if everyone had the same death rates as those living in the highest SES neighborhoods (top third). The subgroups that would most benefit from neighborhood parity are black men and women. In absolute terms, death rates would be reduced by 201.2 deaths per 100,000 person years for black men and 143.1 deaths per 100,000 person years for black women.
It is logical that neighborhood socioeconomic environments affect the overall health of its residents. Perhaps those living in poorer neighborhoods have less access to fresh fruits and vegetables than those living in wealthier communities. Or perhaps educational and employment opportunities are not as readily available. Maybe higher crime rates in under resourced neighborhoods make outdoor exercise unfeasible, or the air and water quality may not be equitable with higher SES neighborhoods. All of these factors and others are possible reasons that living in a low SES neighborhood may increase mortality rates for its residents above and beyond any individual SES factors they have. Given that more than 31 million white, almost 4.5 million African-American and more than 1.5 million Mexican-American women and men live in low SES neighborhoods, the broad implications of this study demonstrate a need to recognize that social, economic and political factors are root causes of poor health.
Secondary findings of the study:
Findings for Mexican-American women were the exception to the other gender and ethnic groups that were studied. The relationship between individual level SES and mortality was significant for Mexican American women, but the relationship between neighborhood level SES and mortality was not, after taking their own SES into account. Perhaps Mexican-American women are protected by cultural and social support networks with strong ties with Mexico that act as buffers against the negative influences of a low SES neighborhood?
Implications and recommendations from the study:
The implications from this study suggest a change in direction in health policy and programs from an individual patient approach to a focus on the broad social environments, particularly for those with low SES. Approaches should consider that an individual’s health behaviors are strongly shaped by the neighborhoods in which she/he lives, and that this makes it necessary to learn about neighborhoods from the people who live in them and/or from critical information about the available goods and services, zoning policies, crime statistics, air pollution levels, and other issues that can directly affect residents and their health. In response to inequalities found in neighborhoods, health professionals can be important advocates in promoting healthy neighborhoods.
Proposed news articles:
- Should policy makers target neighborhood improvement as a means to positively affect citizens’ overall health? Can putting money into neighborhood improvements such as building sidewalks or walking trails, supporting farmer’s markets, and supporting schools to offer quality snacks/foods and increase physical activity ultimately help to stave off disease? Likewise, can local policies create healthier neighborhoods by limiting the number of fast food restaurants and tobacco advertising in neighborhoods?
- Why have many health programs that focus on changing individual health behaviors failed? How can health professionals better tailor messages to distinct communities? What broader approaches need to be incorporated to health behavior change that extends the burden of change from a sole focus on individuals to include a focus on neighborhood change?
