Suchergebnisse

<p><strong>Background</strong>: Neighborhood socioeconomic status (SES) is associated with adverse health outcomes, but longitudinal data among Black Americans, who tend to live in more deprived neighborhoods, is lacking. <br />Objectives: We prospectively assessed the relation of neighborhood SES to mortality in the Black Women's Health Study.</p><p><strong>Design</strong>: A prospective cohort of 59,000 Black women was followed from 1995-2011. Participant addresses were geocoded and US Census block group was identified. Neighborhood SES was measured by a score based on US Census block group data for six indicators of income, education and<br />wealth.</p><p><strong>Main outcome measures:</strong> Deaths were identified through the National Death Index. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% CIs with control for covariates.</p><p><strong>Results</strong>: Based on 2,598 deaths during 1995-2011, lower neighborhood SES was associated with increased all-cause and cancer mortality irrespective of individual education: among those with 16 or more years of education, HRs for lowest relative to highest neighborhood SES quartile were 1.42 (95% CI 1.18-1.71) for all-cause and 1.54 (95% CI 1.14-2.07) for cancer mortality. Neighborhood SES was associated with cardiovascular mortality among lesseducated women.</p><p><strong>Conclusions</strong>: Lower neighborhood SES is associated with greater risk of mortality among Black women. The presence of the association even among women with high levels of education suggests that individual<br />SES may not overcome the unfavorable influence of neighborhood deprivation. <em>Ethn Dis</em>. 2016;26(2):157-164; doi:10.18865/<br />ed.26.2.157</p>

<p><strong>Objective</strong>: Individual socioeconomic status (SES) has been associated with asthma incidence but whether neighborhood<br />SES has an influence is unknown. We assessed the contributions of neighborhood socioeconomic status (SES), neighborhood housing density, neighborhood racial composition, and individual SES to the development of adult-onset asthma in Black<br />women, accounting for other known or suspected risk factors.<br /><strong></strong></p><p><strong>Design and Participants</strong>: Prospective cohort study conducted among 47,779 African American women followed with biennial health questionnaires from 1995 to 2011.<br /><strong></strong></p><p><strong>Methods and Main Outcome Measures</strong>: Incident asthma was defined as new selfreport of doctor-diagnosed asthma with<br />concurrent use of asthma medication. We assessed neighborhood SES, indicated by census variables representing income,<br />education, and wealth, and housing density and % African American population, as well as individual SES, indicated by highest education of participant/spouse. Cox proportional hazards models were used to derive multivariable hazard ratios (HRs) and<br />95% CIs for the association of individual SES and neighborhood variables with asthma incidence.<br /><strong></strong></p><p><strong>Results</strong>: During a 16-year follow-up period, 1520 women reported incident asthma. Neighborhood factors were not associated<br />with asthma incidence after control for individual SES, body mass index, and other factors. Compared with college graduates,<br />the multivariable HR for asthma was 1.13 (95% CI 1.00-1.28) for women with some college education and 1.23 (95% CI 1.05-<br />1.44) for women with no more than a high school education.<br /><strong></strong></p><p><strong>Conclusions</strong>: Individual SES, but not neighborhood SES or other neighborhood factors, was associated with the incidence<br />of adult-onset asthma in this population of African American women. <em>Ethn Dis</em>. 2016;26(1):113-122; doi:10.18865/<br />ed.26.1.113</p><p> </p>