Neighborhood socioeconomic status and all-cause mortality

This study sought to determine the contribution of neighborhood socioeconom ic status to all-cause mortality and to explore its correlates. As part of the longitudinal "Gezondheid en LevensOmstandigheden Bevolking en omstreken " (GLOBE) study in the Netherlands, 8,506 randomly selected men and women a ged 15-74 years from 86 neighborhoods in the city of Eindhoven reported on their socioeconomic status in the 1991 baseline survey. During the 6-year f ollow-up, 487 persons died. Neighborhood socioeconomic status was derived f rom individual reports on socioeconomic status. Its effect on mortality was stringently controlled for four individual-level socioeconomic indicators. Persons living in a neighborhood with a high percentage of unemployed/disa bled or poor persons had a higher mortality risk than did those living in a neighborhood with a low percentage of unemployed/disabled or poor persons. This was independent of individual socioeconomic characteristics, includin g individual unemployment/disability or reports of severe financial problem s. Educational and occupational neighborhood indicators were similarly, but less strongly, related to mortality. The prevalence of poor housing condit ions, social disintegration, and unhealthy psychologic profiles and behavio rs was higher in neighborhoods with a low socioeconomic status. Contextual effects of socioeconomic status may thus be due to one or more of these spe cific circumstances. The findings indicate potential public health benefits of modifying socioeconomic characteristics of areas.