Neighborhood Disadvantage and Self-Reported Health

Self-reported health is a strong predictor of mortality. Residence in a disadvantaged neighborhood can adversely affect conditions such as safety, access to the natural environment, quality of housing, and stress which also influence health. We evaluated the association between self-reported health and neighborhood in a cross-sectional study in central North Carolina. Participants completed a clinic visit and a questionnaire. The questionnaire addressed self-reported health (Excellent, Good, Fair and Poor), medical history and demographics. Participants provided saliva and serum samples to test for a set of health biomarkers. Neighborhood information was obtained from the US Census for the census-block group associated with each participant’s residence. A neighborhood disadvantage index (NDI) was created based on: % without high school degree, % unemployed, % below poverty, % vacant properties, % residences with > 1.5 occupants per room, and % on food assistance. Z-scores were calculated for each of the log-transformed characteristics, summed and categorized in quartiles (1=least disadvantaged; 4=most disadvantaged). Ordinal logistic regression was used to model self-reported health in relation to NDI. Individual measures of age, race, body-mass index, smoking, alcohol, and education were considered as covariates with final models selected by minimizing the AIC. There were 223 participants from 143 block-groups. There was a consistent trend across NDI quartiles with increasing disadvantage associated with worse self-reported health (aOR=1.28, 95% CI =1.02-1.63). Those in the highest NDI (most disadvantaged) were over 2 times (aOR=2.15, 95% CI=1.03-4.56) more likely to report worse heath as those with the lowest NDI. These findings provide additional support for the important contextual effect of neighborhood on health. In future analysis, we will evaluate biomarkers which may mediate this association. This abstract does not represent EPA policy.