MORTALITY EFFECTS OF COMMUNITY SOCIOECONOMIC-STATUS

We linked data from the National Longitudinal Mortality Study to censu s tract information on 239,187 persons to assess 11-year mortality ris k among black and white men and women associated with median census tr act income, adjusted for individual family income from the Current Pop ulation Survey. We stratified Cox proportional hazards models by ages 25-64 years and 65 years and older. We used a robust covariance matrix to obtain standard errors for the model coefficients that account for correlation among individuals in the same census tract. Both income i ndicators were independently related to all-cause mortality. Among per sons age 25-64 years, the rate ratios (RR) for individual family incom e and the median census tract income, respectively, for low income rel ative to high income were RR = 2.10 vs 1.49 for black men, RR = 2.03 v s 1.26 for white men; and RR = 1.92 vs 1.30 for black women and RR = 1 .61 vs 1.16 for white women. Among persons age 65 years or greater, on ly individual family income was associated with mortality, and only fo r white men. Although family income has a stronger association with mo rtality than census tract, our results indicate that, more broadly, ar ea socioeconomic status makes a unique and substantial contribution to mortality and should be explored in health policy and disease prevent ion research.