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No Man is an Island: The Impact of Neighborhood Disadvantage on Mortality

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  • Darrell J. Gaskin

    (Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • Eric T. Roberts

    (Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health; Pittsburgh, PA 15261, USA)

  • Kitty S. Chan

    (Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    MedStar-Georgetown Surgical Outcomes Research Center, MedStar Health Research Institute and Medstar Georgetown University Hospital, Washington, DC 20007, USA)

  • Rachael McCleary

    (Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • Christine Buttorff

    (RAND Corporation, Arlington, VA 22202, USA)

  • Benjo A. Delarmente

    (Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
    Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA)

Abstract

This study’s purpose is to determine if neighborhood disadvantage, air quality, economic distress, and violent crime are associated with mortality among term life insurance policyholders, after adjusting for individual demographics, health, and socioeconomic characteristics. We used a sample of approximately 38,000 term life policyholders, from a large national life insurance company, who purchased a policy from 2002 to 2010. We linked this data to area-level data on neighborhood disadvantage, economic distress, violent crime, and air pollution. The hazard of dying for policyholders increased by 9.8% (CI: 6.0–13.7%) as neighborhood disadvantage increased by one standard deviation. Area-level poverty and mortgage delinquency were important predictors of mortality, even after controlling for individual personal income and occupational status. County level pollution and violent crime rates were positively, but not statistically significantly, associated with the hazard of dying. Our study provides evidence that neighborhood disadvantage and economic stress impact individual mortality independently from individual socioeconomic characteristics. Future studies should investigate pathways by which these area-level factors influence mortality. Public policies that reduce poverty rates and address economic distress can benefit everyone’s health.

Suggested Citation

  • Darrell J. Gaskin & Eric T. Roberts & Kitty S. Chan & Rachael McCleary & Christine Buttorff & Benjo A. Delarmente, 2019. "No Man is an Island: The Impact of Neighborhood Disadvantage on Mortality," IJERPH, MDPI, vol. 16(7), pages 1-18, April.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:7:p:1265-:d:221093
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    References listed on IDEAS

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    Cited by:

    1. Jamie M. Smith & Olga F. Jarrín & Haiqun Lin & Jennifer Tsui & Tina Dharamdasani & Charlotte Thomas-Hawkins, 2021. "Racial Disparities in Post-Acute Home Health Care Referral and Utilization among Older Adults with Diabetes," IJERPH, MDPI, vol. 18(6), pages 1-14, March.
    2. White-Means, Shelley & Gaskin, Darrell J. & Osmani, Ahmad Reshad, 2019. "Intervention and Public Policy Pathways to Achieve Health Care Equity," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 16(14), pages 1-11.
    3. Miguel A. Martinez-Beneito & Carlos Vergara-Hernández & Paloma Botella-Rocamora & Francisca Corpas-Burgos & Jordi Pérez-Panadés & Óscar Zurriaga & Elena Aldasoro & Carme Borrell & Elena Cabeza & Lluís, 2021. "Geographical Variability in Mortality in Urban Areas: A Joint Analysis of 16 Causes of Death," IJERPH, MDPI, vol. 18(11), pages 1-15, May.

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