Population Research and Policy Review

, Volume 37, Issue 2, pp 301–321 | Cite as

Neighborhood Concentrated Disadvantage and Adult Mortality: Insights for Racial and Ethnic Differences

  • Justin T. Denney
  • Jarron M. Saint Onge
  • Jeff A. Dennis


While racial and ethnic differences in mortality are pervasive and well documented, less is known about how mortality risk varies by neighborhood socioeconomic status across racial and ethnic identity. We conducted a prospective analysis on a sample of adults living at or below 300% poverty with 8 years of the National Health Interview Survey (N = 159,400) linked to 11,600 deaths to examine the association between neighborhood disadvantage and mortality for non-Hispanic whites, non-Hispanic blacks, and U.S.- and foreign-born Hispanics. Using multilevel logistic regression, we find that the probability of death from any cause for lower-income adults is higher in more-disadvantaged neighborhoods, compared to less-disadvantaged neighborhoods, but only for whites. The adjusted likelihood of death for blacks and foreign-born Hispanics is not associated with neighborhood disadvantage, and the likelihood of death for U.S.-born Hispanics is lower in more-disadvantaged neighborhoods. While future research and policy should focus on improving health-promoting resources in all communities, care should be given to better understanding why race/ethnic groups have differential mortality returns with respect to area-specific socioeconomic conditions.


Mortality Race Ethnicity Neighborhoods Concentrated disadvantage 



We gratefully acknowledge support and the staff at the Texas Census Research Data Center at Texas A&M. We also thank the staff at the Rocky Mountain Research Data Center and the National Center for Health Statistics Research Data Center in Hyattsville, MD for their assistance and support with the restricted use data components of this research. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of NIH, NCHS, or the U.S. Census Bureau.


  1. Acevedo-Garcia, D., Bates, L. M., Osypuk, T. L., & McArdle, N. (2010). The effect of immigrant generation and duration on self-rated health among us adults 2003–2007. Social Science and Medicine, 71(6), 1161–1172.CrossRefGoogle Scholar
  2. Alesina, A., & La Ferrara, E. (2000). Participation in heterogeneous communities. The Quarterly Journal of Economics, 115(3), 847–904.CrossRefGoogle Scholar
  3. Alesina, A., & La Ferrara, E. (2002). Who trusts others? Journal of Public Economics, 85(2), 207–234.CrossRefGoogle Scholar
  4. Bécares, L., Nazroo, J., Albor, C., Chandola, T., & Stafford, M. (2012). Examining the differential association between self-rated health and area deprivation among white british and ethnic minority people in England. Social Science and Medicine, 74(4), 616–624.CrossRefGoogle Scholar
  5. Bécares, L., Stafford, M., Laurence, J., & Nazroo, J. (2011). Composition, concentration and deprivation: Exploring their association with social cohesion among different ethnic groups in the UK. Urban Studies, 48(13), 2771–2787.CrossRefGoogle Scholar
  6. Bird, C. E., Seeman, T., Escarce, J. J., Basurto-Dávila, R., Finch, B. K., Dubowitz, T., et al. (2010). Neighbourhood socioeconomic status and biological ‘wear and tear’in a nationally representative sample of us adults. Journal of Epidemiology and Community Health, 64, 860–865.CrossRefGoogle Scholar
  7. Borrell, L. N., Diez, A. V., Roux, K. R., Catellier, D., & Clark, B. L. (2004). Neighbourhood characteristics and mortality in the atherosclerosis risk in communities study. International Journal of Epidemiology, 33(2), 398–407.CrossRefGoogle Scholar
  8. Browning, C. R., Wallace, D., Feinberg, S. L., & Cagney, K. A. (2006). Neighborhood social processes, physical conditions, and disaster-related mortality: The case of the 1995 Chicago Heat Wave. American Sociological Review, 71(4), 661–678.CrossRefGoogle Scholar
  9. Case, A., & Deaton, A. (2015). Rising morbidity and mortality in midlife among white Non-Hispanic Americans in the 21st Century. Proceedings of the National Academy of Sciences, 112(49), 15078–15083.CrossRefGoogle Scholar
  10. Cerdá, M., Gaidus, A., Keyes, K. M., Ponicki, W., Martins, S., Galea, S., et al. (2017). Prescription opioid poisoning across urban and rural areas: Identifying vulnerable groups and geographic areas. Addiction, 112(1), 103–112.CrossRefGoogle Scholar
  11. Clampet-Lundquist, S. (2010). Everyone had your back: Social ties, perceived safety, and public housing relocation. City & Community, 9(1), 87–108.CrossRefGoogle Scholar
  12. Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54(10), 805.CrossRefGoogle Scholar
  13. Crowder, K. D., & South, S. J. (2008). Spatial dynamics of white flight: The effects of local and extralocal racial conditions on neighborhood out-migration. American Sociological Review, 73(5), 792–812.CrossRefGoogle Scholar
  14. Desmond, M. (2012). Disposable ties and the urban poor. American Journal of Sociology, 117(5), 1295–1335.CrossRefGoogle Scholar
  15. Dominguez, S., & Watkins, C. (2003). Creating networks for survival and mobility: Social capital among African-American and Latin-American Low-Income mothers. Social Problems, 50(1), 111–135.CrossRefGoogle Scholar
  16. Eschbach, K., Ostir, G. V., Patel, K. V., Markides, K. S., & Goodwin, J. S. (2004). Neighborhood context and mortality among Older Mexican Americans: Is there a Barrio advantage? American Journal of Public Health, 94(10), 1807–1812.CrossRefGoogle Scholar
  17. Eschbach, K., Stimpson, J. P., Kuo, Y.-F., & Goodwin, J. S. (2007). Mortality of foreign-born and Us-Born Hispanic adults at younger ages: A reexamination of recent patterns. American Journal of Public Health, 97(7), 1297–1304.CrossRefGoogle Scholar
  18. Everett, B. G., Saint Onge, J. M., & Mollborn, S. (2016). Effects of minority status and perceived discrimination on mental health. Population Research and Policy Review, 35(4), 445–469.CrossRefGoogle Scholar
  19. Fenelon, A. (2017). Rethinking the Hispanic Paradox: The mortality experience of mexican immigrants in traditional gateways and new destinations. International Migration Review, 51(3), 567–599.CrossRefGoogle Scholar
  20. Fitzpatrick, K., & LaGory, M. (2013). Unhealthy cities: Poverty, race, and place in america. Florence Taylor and Francis: Routledge.Google Scholar
  21. Franzini, L., Ribble, J. C., & Keddie, A. M. (2001). Understanding the Hispanic paradox. Ethnicity and Disease, 11(3), 496–518.Google Scholar
  22. Gelman, A., & Hill, J. (2007). Data analysis using regression and multilevel/hierarchical models. New York: Cambridge University Press.Google Scholar
  23. Glaser, R., & Kiecolt-Glaser, J. K. (2005). Stress-induced immune dysfunction: Implications for health. Nature Reviews Immunology, 5(3), 243–251.CrossRefGoogle Scholar
  24. Guo, G., & Zhao, H. (2000). Multilevel modeling for binary data. Annual Review of Sociology, 26, 441–462.CrossRefGoogle Scholar
  25. Hummer, R. A., Rogers, R. G., Amir, S. H., Forbes, D., & Frisbie, W. P. (2000). Adult mortality differentials among Hispanic subgroups and Non-Hispanic whites. Social Science Quarterly, 81(1), 459–476.Google Scholar
  26. Iceland, John. (2014). A portrait of America: The demographic perspective. Berkeley, CA: University of California Press.Google Scholar
  27. Inagami, S., Borrell, L. N., Wong, M. D., Fang, J., Shapiro, M. F., & Asch, S. M. (2006). Residential segregation and Latino, Black and White mortality in New York City. Journal of Urban Health, 83(3), 406–420.CrossRefGoogle Scholar
  28. Inagami, S., Cohen, D. A., & Finch, B. K. (2007). Non-residential neighborhood exposures suppress neighborhood effects on self-rated health. Social Science and Medicine, 65(8), 1779–1791.CrossRefGoogle Scholar
  29. James, S. A. (1994). John Henryism and the Health of African-Americans. Culture, medicine and psychiatry, 18(2), 163–182.CrossRefGoogle Scholar
  30. James, W., & Cossman, J. S. (2017). Long-term trends in Black and White mortality in the rural United States: Evidence of a race-specific rural mortality penalty. The Journal of Rural Health, 33(1), 21–31.CrossRefGoogle Scholar
  31. Jencks, C., & Mayer, S. E. (1990). The Social Consequences of Growing up in a Poor Neighborhood. In L. E. Lynn & M. G. H. McGeary (Eds.), Inner-city poverty in the United States (pp. 111–185). Washington, D.C.: National Academy Press.Google Scholar
  32. Kawachi, I., & Berkman, L. F. (Eds.). (2003). Neighborhoods and health. New York: Oxford University Press.Google Scholar
  33. Krieger, N. (1990). Racial and gender discrimination: Risk factors for high blood pressure? Social Science and Medicine, 30(12), 1273–1281.CrossRefGoogle Scholar
  34. Krieger, N. (2001). Theories for social epidemiology in the 21st Century: An ecosocial perspective. International Journal of Epidemiology, 30(4), 668–677.CrossRefGoogle Scholar
  35. Krivo, L. J., Washington, H. M., Peterson, R. D., Browning, C. R., Calder, C. A., & Kwan, M.-P. (2013). Social isolation of disadvantage and advantage: The reproduction of inequality in urban space. Social Forces, 92(1), 141–164.CrossRefGoogle Scholar
  36. Lariscy, J. T. (2017). Black–White disparities in adult mortality: Implications of differential record linkage for understanding the mortality crossover. Population Research and Policy Review, 36(1), 137–156.CrossRefGoogle Scholar
  37. LeClere, F. B., Rogers, R. G., & Peters, K. D. (1997). Ethnicity and mortality in the United States: Individual and community correlates. Social Forces, 76, 169–198.CrossRefGoogle Scholar
  38. Lee, M. A., & Ferraro, K. F. (2007). Neighborhood residential segregation and physical health among Hispanic Americans: Good, bad, or benign? Journal of Health and Social Behavior, 48(2), 131–148.CrossRefGoogle Scholar
  39. Leventhal, T., & Brooks-Gunn, J. (2000). The neighborhoods they live in: The effects of neighborhood residence on child and adolescent outcomes. Psychological Bulletin, 126(2), 309.CrossRefGoogle Scholar
  40. Lindstrom, D. P., & Ramírez, A. L. (2010). Pioneers and followers: Migrant selectivity and the development of us migration streams in Latin America. The Annals of the American Academy of Political and Social Science, 630(1), 53–77.CrossRefGoogle Scholar
  41. Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior.  https://doi.org/10.2307/2626958.Google Scholar
  42. Lumpkins, C. Y., & Saint Onge, J. M. (2017). Reducing low birth weight among African Americans in the midwest: A look at how faith-based organizations are poised to inform and influence health communication on the developmental origins of health and disease (Dohad). Healthcare, 5(1), 6.CrossRefGoogle Scholar
  43. Macintyre, S., & Ellaway, A. (2000). Ecological approaches: Resicovering the role of Th phsical and social environment. In L. F. Berkman & I. Kawachi (Eds.), Social, epidemiology (pp. 332–348). Oxford: Oxford University Press.Google Scholar
  44. Markides, K. S., & Eschbach, K. (2005). Aging, migration, and mortality: Current status of research on the Hispanic paradox. Journals of Gerontology: Series B, 60, 68–75.CrossRefGoogle Scholar
  45. Markides, K. S., & Eschbach, K. (2011). Hispanic paradox in adult mortality in the United States. In R. G. Rogers & E. M. Crimmins (Eds.), International handbook of adult mortality (pp. 227–240). Dordrecht: Springer, Netherlands.CrossRefGoogle Scholar
  46. Masters, R. K., Tilstra, A. M., & Simon, D. H. (2017). Explaining recent mortality trends among younger and middle-aged White Americans. International Journal of Epidemiology.  https://doi.org/10.1093/ije/dyx127:1-8.Google Scholar
  47. McEwen, B. S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840(1), 33–44.CrossRefGoogle Scholar
  48. Meijer, M., Röhl, J., Bloomfield, K., & Grittner, U. (2012). Do neighborhoods affect individual mortality? A systematic review and meta-analysis of multilevel studies. Social Science and Medicine, 74(8), 1204–1212.CrossRefGoogle Scholar
  49. Menjivar, C. (2000). Fragmented Ties: Salvadoran Immigrant Networks in America. Berkeley, CA: University of California Press.Google Scholar
  50. Minnesota Population Center. (2013). Integrated health interview series: Version 5.0. Minneapolis: University of Minnesota.Google Scholar
  51. Morenoff, J. D. (2003). Neighborhood mechanisms and the spatial dynamics of birth weight. American Journal of Sociology, 108(5), 976–1017.CrossRefGoogle Scholar
  52. Mouw, T., Chavez, S., Edelblute, H., & Verdery, A. (2014). Binational social networks and assimilation: A test of the importance of transnationalism. Social Problems, 61(3), 329–359.CrossRefGoogle Scholar
  53. National Center for Health Statistics (NCHS). (1997–2004). National Health Interview Surveys: Core Data. Washington, DC: National Institutes of Health.Google Scholar
  54. National Center for Health Statistics (NCHS). (2016). Linkage methods and analytical support for Nchs linked mortality data. Washington, DC: National Institutes of Health.Google Scholar
  55. Newman, K. S. (1992). Culture and structure in the truly disadvantaged. City & Society, 6(1), 3–25.CrossRefGoogle Scholar
  56. Noh, S., & Kaspar, V. (2003). Perceived discrimination and depression: Moderating effects of coping, acculturation, and ethnic support. American Journal of Public Health, 93(2), 232–238.CrossRefGoogle Scholar
  57. O’Campo, P., Xue, X., Wang, M.-C., & Caughy, M. (1997). Neighborhood risk factors for low birthweight in Baltimore: A multilevel analysis. American Journal of Public Health, 87(7), 1113–1118.CrossRefGoogle Scholar
  58. Olshansky, S. J., Antonucci, T., Berkman, L., Binstock, R. H., Boersch-Supan, A., Cacioppo, J. T., et al. (2012). Differences in life expectancy due to race and educational differences are widening, and many may not catch up. Health Affairs, 31(8), 1803–1813.CrossRefGoogle Scholar
  59. Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010). Socioeconomic disparities in health behaviors. Annual Review of Sociology, 36, 349–370.CrossRefGoogle Scholar
  60. Parker, R. N., & Fenwick, R. (1983). The pareto curve and its utility for open-ended income distributions in survey research. Social Forces, 61, 873–885.CrossRefGoogle Scholar
  61. Pickett, K. E., & Wilkinson, R. G. (2008). People like us: Ethnic group density effects on health. Ethnic Health, 13(4), 321–334.CrossRefGoogle Scholar
  62. Pieterse, A. L., & Carter, R. T. (2007). An examination of the relationship between general life stress, racism-related stress, and psychological health among Black Men. Journal of Counseling Psychology, 54(1), 101–109.CrossRefGoogle Scholar
  63. Putnam, R. D. (1995). Bowling Alone: America’s Declining Social Capital. Journal of Democracy, 6, 68.CrossRefGoogle Scholar
  64. Rabe-Hesketh, S., & Skrondal, A. (2008). Multilevel and longitudinal modeling using stata. College Station, TX: StataCorp.Google Scholar
  65. Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models. Thousand Oaks, CA: Sage Publications.Google Scholar
  66. Sampson, R. J. (2012). Great American City: Chicago and the enduring neighborhood effect. Chicago, IL: University of Chicago Press.CrossRefGoogle Scholar
  67. Sampson, R. J., Raudenbush, S. W., & Earls, F. (1997). Neighborhoods and violent crime: A multilevel study of collective efficacy. Science, 277(5328), 918–924.CrossRefGoogle Scholar
  68. Seeman, T. E., Singer, B. H., Rowe, J. W., Horwitz, R. I., & McEwen, B. S. (1997). Price of adaptation—Allostatic load and its health consequences: Macarthur studies of successful aging. Archives of Internal Medicine, 157(19), 2259–2268.CrossRefGoogle Scholar
  69. Sharkey, P. (2013). Stuck in place: Urban neighborhoods and the end of progress toward racial equality. Chicago, IL: University of Chicago Press.CrossRefGoogle Scholar
  70. Signorello, L. B. (2014). Socioeconomic status, race, and mortality: A prospective cohort study. American Journal of Public Health, 104(12), e98–e107.CrossRefGoogle Scholar
  71. Signorello, L. B., Cohen, S. S., Williams, D. R., Munro, H. M., Hargreaves, M. K., & Blot, W. J. (2014). Socioeconomic status, race, and mortality: A prospective cohort study. American Journal of Public Health, 104(12), e98–e107.CrossRefGoogle Scholar
  72. Swaroop, S., & Morenoff, J. D. (2006). Building community: The neighborhood context of social organization. Social Forces, 84(3), 1665–1695.CrossRefGoogle Scholar
  73. Turra, C. M., & Elo, I. T. (2008). The impact of salmon bias on the Hispanic mortality advantage: New evidence from Social Security data. Population Research and Policy Review, 27(5), 515–530.CrossRefGoogle Scholar
  74. Van der Gaag, J., & Smolensky, E. (1982). True household equivalence scales and characteristics of the poor in the United States. Review of Income and Wealth, 28(1), 17–28.CrossRefGoogle Scholar
  75. Waitzman, N. J., & Smith, K. R. (1998). Phantom of the area: Poverty-area residence and mortality in the United States. American Journal of Public Health, 88(6), 973–976.CrossRefGoogle Scholar
  76. Walton, Emily. (2016). It’s not just a bunch of buildings: Social psychological investment, sense of community, and collective efficacy in a multiethnic low-income neighborhood. City & Community, 15(3), 231–263.CrossRefGoogle Scholar
  77. Wight, R. G., Cummings, J. R., Karlamangla, A. S., & Aneshensel, C. S. (2010). Urban neighborhood context and mortality in late life. Journal of Aging and Health, 22(2), 197–218.CrossRefGoogle Scholar
  78. Williams, D. R. (1997). Race and health: Basic questions, emerging directions. Annals of Epidemiology, 7(5), 322–333.CrossRefGoogle Scholar
  79. Wilson, W. J. (2009). More than just race: Being Black and poor in the inner city (issues of our time). New York: WW Norton & Company.Google Scholar
  80. Wilson, K. B., Thorpe, R. J., & LaVeist, T. A. (2017). Dollar for Dollar: Racial and ethnic inequalities in health and health-related outcomes among persons with very high income. Preventive Medicine, 96, 149–153.CrossRefGoogle Scholar
  81. Winkleby, M., Cubbin, C., & Ahn, D. (2006). Effect of cross-level interaction between individual and neighborhood socioeconomic status on adult mortality rates. American Journal of Public Health, 96(12), 2145–2153.CrossRefGoogle Scholar
  82. Wu, Y., Sun, I. Y., & Triplett, Ruth A. (2009). Race, class or neighborhood context: which matters more in measuring satisfaction with police? Justice Quarterly, 26(1), 125–156.CrossRefGoogle Scholar
  83. Yen, I. H., & Kaplan, G. A. (1999). Neighborhood social environment and risk of death: multilevel evidence from the alameda county study. American Journal of Epidemiology, 149(10), 898–907.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Justin T. Denney
    • 1
  • Jarron M. Saint Onge
    • 2
  • Jeff A. Dennis
    • 3
  1. 1.Department of SociologyWashington State UniversityPullmanUSA
  2. 2.University of KansasLawrenceUSA
  3. 3.Department of Public HealthTexas Tech University Health Sciences CenterLubbockUSA

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