 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Marilyn A. Winkleby, PhD, MPH, Catherine Cubbin, PhD, Ying-Chih Chuang, PhD, David Ahn, and Namita Oswal. Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, 1000 Welch Road, Palo Alto, CA 94304-1825, 650-723-7055, winkleby@stanford.edu
Purpose: This study examines (1) whether women and men living in neighborhoods with disadvantaged social and/or physical environments experience higher all-cause mortality than those living in more advantaged neighborhoods, after accounting for individual sociodemographic characteristics (e.g., age, race/ethnicity, marital status, education, income), and (2) whether individual health behaviors and risk factors (e.g., smoking, diet, exercise, obesity, blood pressure) mediate the relationship between neighborhood environments and mortality. Methods: Individual data are from a prospective mortality follow-up study of 8,419 women and men, aged 25-74, who were initially examined from 1979 to 1990 as part of the Stanford Heart Disease Prevention Program (SHDPP). By 2002, 1004 (13%) of these individuals had died. The SHDPP participants were from four Northern California cities and lived in 82 neighborhoods (defined using a combination of census tracts and block-groups). Neighborhood social and physical environments were measured using both census data (e.g., median income, proportion of female-headed households, ethnic concentration) and historical data on the geographic density and proximity of goods (e.g., fast food restaurants, alcohol outlets, grocery stores), services (educational, banking, health facilities), and community resources (recreational spaces, social organizations). Individual-level data for the 8,419 SHDPP participants and neighborhood-level data measuring goods, services, and resources were geocoded and linked with 1980 and 1990 census data. Analyses: Main analyses will be conducted using multi-level Cox proportional hazards models. Results: Results will show whether neighborhood social and physical environments influence people’s health above and beyond their own individual characteristics and will suggest possible pathways in this relationship.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.