People living in poorer neighborhoods at increased risk for death, worse health risks

Researchers conducted the NIH-AARP Diet and Health Study and found that people living in poorer neighborhoods, as determined by U.S. Census data, reported higher health risks, including heart disease and cancer, and were more likely to die sooner regardless of lifestyle and other risk factors.

"We were expecting that once we controlled for these lifestyle and medical risk factors, the differences would go away," said Chyke Doubeni, M.D., M.P.H., assistant professor of family medicine and community health and assistant vice provost for diversity at the University of Massachusetts Medical School. "We weren't surprised by the unadjusted differences, but we were surprised that the differences persisted after controlling for lifestyle factors such as smoking, diet, exercise and medical risks."

Previous data have demonstrated that people from lower socioeconomic groups have poorer health outcomes. Doubeni and colleagues prospectively evaluated whether people living in more deprived neighborhoods have a higher mortality risk.

Through the NIH-AARP study, they collected diet, lifestyle and medical history data from a prospective cohort of 565,697 participants, aged 50 to 71, from six U.S. states and two metropolitan areas during 1995 to 1996. Participants' mean age was 62 years, and the cohort consisted of 60 percent men, 91 percent non-Hispanic whites, 4 percent non-Hispanic blacks and 9 percent had a history of cancer.

Results revealed that a larger percentage of participants living in the most deprived neighborhoods reported poorer general health, higher average body mass index and lower Mediterranean diet scores, meaning that their diets were unhealthy. After Doubeni and colleagues controlled for dietary and lifestyle factors, the risk for death increased as the levels of deprivation in the neighborhood increased.

"We, as practitioners, either in the health care systems or clinics, should be alert to the needs of people from these backgrounds," Doubeni said. "We need to target public health interventions to these neighborhoods that are deprived by improving health resources and the physical environments in those areas."

Doubeni and colleagues are currently evaluating how living in a socioeconomically deprived neighborhood may influence overall cancer incidence and mortality, specifically focusing on colorectal cancer.