American Journal of Epidemiology Vol. 149, No. 10: 898-907
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health
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Neighborhood Social Environment and Risk of Death: Multilevel Evidence from the Alameda County Study
1School of Public Health, University of California Berkeley, CA
2School of Public Health, University of Michigan Ann Arbor, Ml
Reprint requests to Dr. Irene H. Yen, Behavioral Risk Factors Training Program, School of Public Health, 140 Warren Hall, Box 7360, University of California, Berkeley, CA 94720-7360.
Recent reports suggest the importance of associations between residential area characteristics and health status, but most research uses only census data to measure these characteristics. The current research examined the effect of overall neighborhood social environment on 11-year risk of death. On the basis of data, the authors developed a three-component neighborhood social environment scale: 1) commercial stores; 2) population socioeconomic status; and 3) environment/housing. Data from the 1983 wave of the Alameda County Study (n = 1,129) and deaths over 11 years were analyzed with two-level logistic regression models. Age- and sex-adjusted risk of death was higher for residents in low social environment neighborhoods (odds ratio = 1.58, 95% confidence interval 1.15–2.18). Mortality risks were significantly higher in neighborhoods with a low social environment, even after account was taken of individual income level, education, race/ethnicity, perceived health status, smoking status, body mass index, and alcohol consumption. When each component of the neighborhood social environment characteristics score was examined separately, each was found to be associated with higher risk for mortality, independent of individual risk factors. These findings demonstrate the role of area characteristics as a health risk factor and point to the need for more focused attention to the meaning and measurement of neighborhood quality. Am J Epidemiol 1999; 149: 898–907.
mortality; social class; social environment; socioeconomic factors
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