Relationship of neighborhood and individual socioeconomic status on mortality among older adults: Evidence from cross-level interaction analyses

The influence of community context and individual socioeconomic status on health is widely recognized. However, the dynamics of how the relationship of neighborhood context on health varies by individual socioeconomic status is less well understood. To examine the relationship between neighborhood c...

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Published in:PloS one 2022-05, Vol.17 (5), p.e0267542-e0267542
Main Author: Kim, Taehyun
Format: Article
Language:English
Subjects:
Activities of daily living
Adults
Aged
Angina pectoris
Beneficiaries
Biology and Life Sciences
Cardiovascular disease
Chronic conditions
Chronic illnesses
Community
Context
Deprivation
Earth Sciences
Economic aspects
Family income
Government programs
Health aspects
Health risks
Hispanic people
Home ownership
Households
Income
Logit models
Low income groups
Medicare
Medicine and Health Sciences
Mental health
Minority & ethnic groups
Mortality
Mortality risk
Neighborhoods
Older people
People and Places
Polls & surveys
Research and Analysis Methods
Research design
Social aspects
Social classes
Social Sciences
Socioeconomic factors
Socioeconomic status
Socioeconomics
Surveys
Underweight
Variables
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description The influence of community context and individual socioeconomic status on health is widely recognized. However, the dynamics of how the relationship of neighborhood context on health varies by individual socioeconomic status is less well understood. To examine the relationship between neighborhood context and mortality among older adults and examine how the influence of neighborhood context on mortality differs by individual socioeconomic status, using two measures of income-level and homeownership. A retrospective study of 362,609 Medicare Advantage respondents to the 2014-2015 Medicare Health Outcomes Survey aged 65 and older. Neighborhood context was defined using the deciles of the Area Deprivation Index. Logistic regression was used to analyze mortality with interaction terms between income/homeownership and neighborhood deciles to examine cross-level relationships, controlling for age, gender, race/ethnicity, number of chronic conditions, obese/underweight, difficulties in activities of daily living, smoking status, and survey year. Predicted mortality rates by group were calculated from the logistic model results. Low-income individuals (8.9%) and nonhomeowners (9.1%) had higher mortality rates compared to higher-income individuals (5.3%) and homeowners (5.3%), respectively, and the differences were significant across all neighborhoods even after adjustment. With regression adjustment, older adults residing in less disadvantaged neighborhoods showed lower predicted 2-year mortality among high-income (4.86% in the least disadvantaged neighborhood; 6.06% in the most disadvantaged neighborhood; difference p-value
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However, this study did not observe a significant difference in predicted mortality rates among low-income individuals by neighborhood (8.7% in the least disadvantaged neighborhood; 8.61% in the most disadvantaged neighborhood; difference p-value = 0.825). Low-income or non-homeowning older adults had a higher risk of mortality regardless of neighborhood socioeconomic status. 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However, the dynamics of how the relationship of neighborhood context on health varies by individual socioeconomic status is less well understood. To examine the relationship between neighborhood context and mortality among older adults and examine how the influence of neighborhood context on mortality differs by individual socioeconomic status, using two measures of income-level and homeownership. A retrospective study of 362,609 Medicare Advantage respondents to the 2014-2015 Medicare Health Outcomes Survey aged 65 and older. Neighborhood context was defined using the deciles of the Area Deprivation Index. Logistic regression was used to analyze mortality with interaction terms between income/homeownership and neighborhood deciles to examine cross-level relationships, controlling for age, gender, race/ethnicity, number of chronic conditions, obese/underweight, difficulties in activities of daily living, smoking status, and survey year. Predicted mortality rates by group were calculated from the logistic model results. Low-income individuals (8.9%) and nonhomeowners (9.1%) had higher mortality rates compared to higher-income individuals (5.3%) and homeowners (5.3%), respectively, and the differences were significant across all neighborhoods even after adjustment. With regression adjustment, older adults residing in less disadvantaged neighborhoods showed lower predicted 2-year mortality among high-income (4.86% in the least disadvantaged neighborhood; 6.06% in the most disadvantaged neighborhood; difference p-value&lt;0.001) or homeowning individuals (4.73% in the least disadvantaged neighborhood; 6.25% in the most disadvantaged neighborhood; difference p-value&lt;0.001). However, this study did not observe a significant difference in predicted mortality rates among low-income individuals by neighborhood (8.7% in the least disadvantaged neighborhood; 8.61% in the most disadvantaged neighborhood; difference p-value = 0.825). Low-income or non-homeowning older adults had a higher risk of mortality regardless of neighborhood socioeconomic status. While living in a less disadvantaged neighborhood provided a protective association for higher-income or homeowning older adults, low-income older adults did not experience an observable benefit.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>35588127</pmid><doi>10.1371/journal.pone.0267542</doi><tpages>e0267542</tpages><orcidid>https://orcid.org/0000-0001-8665-1821</orcidid><oa>free_for_read</oa></addata></record>
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1932-6203
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subjects Activities of daily living
Adults
Aged
Angina pectoris
Beneficiaries
Biology and Life Sciences
Cardiovascular disease
Chronic conditions
Chronic illnesses
Community
Context
Deprivation
Earth Sciences
Economic aspects
Family income
Government programs
Health aspects
Health risks
Hispanic people
Home ownership
Households
Income
Logit models
Low income groups
Medicare
Medicine and Health Sciences
Mental health
Minority & ethnic groups
Mortality
Mortality risk
Neighborhoods
Older people
People and Places
Polls & surveys
Research and Analysis Methods
Research design
Social aspects
Social classes
Social Sciences
Socioeconomic factors
Socioeconomic status
Socioeconomics
Surveys
Underweight
Variables
title Relationship of neighborhood and individual socioeconomic status on mortality among older adults: Evidence from cross-level interaction analyses
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T19%3A15%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Relationship%20of%20neighborhood%20and%20individual%20socioeconomic%20status%20on%20mortality%20among%20older%20adults:%20Evidence%20from%20cross-level%20interaction%20analyses&rft.jtitle=PloS%20one&rft.au=Kim,%20Taehyun&rft.date=2022-05-19&rft.volume=17&rft.issue=5&rft.spage=e0267542&rft.epage=e0267542&rft.pages=e0267542-e0267542&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0267542&rft_dat=%3Cgale_plos_%3EA704328317%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c692t-ec442d6391daf96e8b301eaf8c4421d7ebd3ea7f34696f7acdd7fa7cf7c9a2193%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2686258999&rft_id=info:pmid/35588127&rft_galeid=A704328317&rfr_iscdi=true