Evaluating Options for Measurement of Neighborhood Socioeconomic Context

Evidence from a Myocardial Infarction Case-Control Study

Socioeconomic characteristics of a neighborhood have been associated with the health of its residents. The authors examine a group of neighborhoods in Washington state to discover that education-based measurements are the strongest predictors for the risk of myocardial infarction.

The association between neighborhood characteristics and residents' health has been widely documented, despite variations in the measurement of socioeconomic factors across studies. In this analysis, the authors investigate the connection between the incidence of myocardial infarction (MI) and certain neighborhood traits. To ascertain neighborhood context, the researchers measured median household income, the percentage of residents below poverty level, percentage of owner-occupied housing units, proportion of adults at least 25 years old with a high school education, and proportion of individuals at least 25 years old with a college degree. The data were collected from Group Health, a large HMO in Washington state. The final study group consisted of 2,360 participants.

Key Findings:

  • Education-based measurements were the strongest and most consistent predictors of MI risk, in particular college degree attainment, followed by income and poverty.
  • Owner occupancy rates were not associated with MI risk.
  • The results were consistent across all neighborhood definitions, including smaller scale ones.

These findings suggest that some of the links between health and neighborhoods are robust to different scales of measurement. Future research should examine ways that socioeconomic health disparities are generated and sustained, as well as strategies to reduce these disparities.