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Associations of Neighborhood Socioeconomic Disadvantage With Chronic Conditions by Age, Sex, Race, and Ethnicity in a Population-Based Cohort

      Abstract

      Objective

      To determine the association of socioeconomic status at the census block group level with chronic conditions and to determine whether the associations differ by age, sex, race, or ethnicity.

      Methods

      Adults aged 20 years and older on April 1, 2015, from 7 counties in southern Minnesota were identified using the Rochester Epidemiology Project records-linkage system. We estimated the prevalence of 19 chronic conditions (7 cardiometabolic, 7 other somatic, and 5 mental health conditions) at the individual level and a composite measure of neighborhood socioeconomic disadvantage (the area deprivation index [ADI]) at the census block group level (n=249).

      Results

      Among the 197,578 persons in our study, 46.7% (92,373) were male, 49.5% (97,801) were aged 50 years and older, 12.3% (24,316) were of non-White race, and 5.3% (10,546) were Hispanic. The risk of most chronic conditions increased with increasing ADI. For each cardiometabolic condition and most other somatic and mental health conditions, the pattern of increasing risk across ADI quintiles was attenuated, or there was no association across quintiles of ADI in the oldest age group (aged ≥70 years). Stronger associations between ADI and several cardiometabolic, other somatic, and mental health conditions were observed in women.

      Conclusion

      Higher ADI was associated with increased risk of most chronic conditions, with more pronounced associations in younger persons. For some chronic conditions, the associations were stronger in women. Our findings underscore the importance of recognizing the overall and potentially differential impact of area-level deprivation on chronic disease outcomes for diverse populations.

      Keywords

      Abbreviations and Acronyms:

      ADI (area deprivation index), E-REP (expanded Rochester Epidemiology Project), OR (odds ratio), REP (Rochester Epidemiology Project)
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      Linked Article

      • Leveraging Community Information to Improve Health Equity
        Mayo Clinic ProceedingsVol. 97Issue 1
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          In this issue of Mayo Clinic Proceedings, Chamberlain et al1 report that a composite measure of neighborhood socioeconomic disadvantage is positively correlated with increased risk of most chronic conditions, with more pronounced associations in younger adults. This exploration of associations between community-level socioeconomic disadvantages and chronic condition prevalence by age, race, ethnicity, and sex is an important step in understanding and eradicating lingering racial and ethnic disparities among Americans’ health and life chances.
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