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Objectives: The purpose of the study was to conduct a national multivariate analysis on poverty-area residence and mortality in the United States., Methods: Proportional hazards analyses were performed of the effect of poverty-area residence on the risk of mortality among adult examinees in the 1971 through 1974 National Health and Nutrition Examination Survey who were followed through 1987., Results: Poverty-area residence was associated with significantly elevated risk of all-cause mortality (rate ratio = 1.78, 95% confidence interval = 1.33, 2.38) and some cause-specific mortality among those aged 25 through 54 years, but not among those aged 55 through 74 years, at baseline after adjustment for several individual and household characteristics., Conclusions: Residence in poverty areas contributes to socioeconomic gradients in mortality among nonelderly adults in the United States.

The increase in income inequality in the United States over the past 20 years has been accompanied by a pronounced increase in economic segregation in urban areas. No research to date has analyzed the potential effects of such spatial segregation on mortality. To investigate these effects, the mortality experience of respondents aged 30 years and older on the 1986-94 National Health Interview Surveys residing in any one of 30 large metropolitan areas in the United States was analyzed. Concentrated poverty was associated with significantly elevated risk of mortality, even after controlling for individual household income. Concentrated affluence showed a consistent, protective effect only among the elderly. The effects were most pronounced among the poor, but were not confined to them. Urban planning should take into account the effects associated with economic residential segregation.

Purpose: The purpose of this paper is to consider whether the mortality risks associated with marital status are conditioned by the socioeconomic quality of neighborhoods., Methods: The analysis is based on the first National Health and Nutrition Examination Survey 1971-1974 (NHANES I), and the 1987 NHANES I Epidemiologic Followup Survey (NHEFS). Cox proportional hazards regressions were used to assess whether the effect of marital status on the risk of all-cause and cause-specific mortality is altered by local area poverty. Analyses are stratified by age, sex, and urbanicity., Results: The interaction between neighborhood poverty and marital status is suggested for non-elderly men, particularly for cancer mortality and for men in urban areas. Interaction effects are evident among older women residing in urban areas., Conclusions: The absence of a spouse elevates the risk of mortality but this risk is moderately higher in impoverished neighborhoods, notably in urbanized areas, for non-elderly men and elderly women. Future studies with larger samples of non-married persons where marital status changes are incorporated are needed to improve our understanding of the joint mortality effects of local area poverty and marital status.

The purpose of this paper is to examine the hypothesis that marital and poverty status interact in their effects on mortality risks beyond their main effects. This study examines the epidemiological bases for applying an additive rather than a multiplicative specification when testing for interaction between two discrete risk factors. We specifically predict that risks associated with being nonmarried and with being poor interact to produce mortality risks that are greater than each risk acting independently. The analysis is based on men and women who were ages 25-74 during the 1971-1975 National Health and Nutrition Examination Survey I (NHANES I) and who were traced successfully in the NHANES I Epidemiologic Follow-Up Study in 1982-1984. Overall, being both poor and nonmarried places nonelderly (ages 25-64) men, but not women, at risk of mortality greater than that expected from the main effects. This study shows that for all-cause mortality, marital and poverty status interact for men but less so for women; these findings exist when interaction is assessed with either a multiplicative or an additive standard. This difference is most pronounced for poor, widowed men and (to a lesser degree) poor, divorced men. For violent/accidental deaths among men, the interaction effects are large on the basis of an additive model. Weak main and interaction effects were detected for the elderly (age 65+).