LIVING IN A POOR NEIGHBORHOOD CAN BE HAZARDOUS TO YOUR HEALTH
Take two imaginary people. Give them the same ages, health problems, income, marital status, diets, and drinking or smoking habits. Then put one person in a poor neighborhood and the other in a non-poor environment.
Who is most likely to die first?
People who live in poverty areas, regardless of their health, dietary habits, marital status, race, or household income levels have a mortality rate that's about 80 percent higher than comparable people who don't live in poor areas, say two researchers from the University of Utah.
The research challenges widely held beliefs that people who live in poverty areas die sooner strictly because of violence, risky personal behaviors, or from inadequate access to health care.
"The characteristics of where you live -- independent of your own, personal characteristics -- can be a significant factor for mortality," says Professor Norman J. Waitzman, one of the study's co-authors.
The study, published today in the June issue of the American Journal of Public Health, was conducted by Waitzman, an associate professor of economics, and Professor Ken Smith, a sociologist in the Department of Family and Consumer Studies.
The research marks the first time a national-level analysis has been performed on poverty-area residence and mortality in the United States. It is also the first study to examine neighborhood poverty -- which is growing in the U.S. -- and individual risk of death from specific causes.
Waitzman and Smith analyzed data from the first National Health and Nutrition Examination Survey (NHANES) conducted between 1971 and 1975. The same respondents were tracked up to 1987 as part of the NHANES I Epidemiologic Follow- up Survey in order to identify those who had survived or died. The NHANES survey is one of the largest nationally representative samples in which both a medical exam and an extensive interview were administered to the participants.
In all, Waitzman and Smith examined the records of about 10,000 adults ages 25-74 who lived in either poverty or non-poverty areas. Poverty areas are federally designated areas with high unemployment, low median family incomes, and large percentages of female-headed households and adults without a high school education.
The researchers studied the risks of death associated with poverty area residents after controlling for each person's physical, behavioral and personal characteristics, as well as for their household income levels and other demographic factors.
They found that living in a poverty area had significantly increased the risk of death by 80 percent, across all causes of death, especially among adults ages 25-54.
"Our guess is that the 80 percent figure is a conservative estimate, because some poverty-area residents who moved to better neighborhoods had lower risks of death, even though they started in a poor area," Smith says.
Waitzman and Smith have not yet identified the exact factors which increase death rates among poverty area residents. But they believe social support and community-level economic investments play a crucial role since the death risks could not be directly attributed to well-known risk factors.
"An important aspect of our findings is social cohesion and integration -- a kind of social glue," Smith says. "We suspect that residents in poorer areas may have less social integration, leading to more stress and feelings of despair. Poverty-area residents adapt to their living circumstances by calling on friends and family, but it is likely that these sources of social support are less effective in poorer neighborhoods."
Another contributor to the excessive death rate might be related to the level of economic investment in poorer neighborhoods, says Waitzman, a health economist. "Poor neighborhoods have fewer jobs and new businesses as well as limited and under-funded schools and public health facilities," he says.
Although non-poor residents also experience isolation, it may not have the same dramatic effect on their health, Waitzman says. "The wealthy can substitute private resources for the absence of support more readily than the poor," he says. "They compensate."
"There needs to be a public response to public problems," Waitzman says. "We need to work to maintain investments in neighborhoods to keep them vital, to re- evaluate zoning laws to ensure economic integration, and to sustain investments in schools and public amenities."
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Contact: Norman Waitzman, (801) 581-7600;
Ken Smith, (801) 581-7847
Writer: Karen Wolf, (801) 581-4628
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