esearchers have known for some time that health tends to be related to factors such as education and income. But a long-range study involving Carolina researchers has recently shown that where you live can also affect your health, regardless of your education, income, or occupation. The study’s authors included Lloyd Chambless, research professor of biostatistics, and Herman Tyroler, professor emeritus of epidemiology.

The researchers tracked 13,000 people aged 45 to 64 and gathered an average of nine years’ health data on each person. Then they set out to measure whether subjects’ neighborhoods affected their incidence of heart disease. The researchers used a method developed by the U.S. Census Bureau to designate neighborhoods. For this study, they focused on 595 census "block-groups" in four areas: Forsyth County, North Carolina; Jackson, Mississippi; Minneapolis, Minnesota; and Washington County, Maryland.

The researchers then determined a socioeconomic "score" for the different block-groups in which participants lived. They scored the block-groups using wealth and income variables (median household income, median value of housing units, and percentage of households receiving interest or rental income), education variables (percentage of adults who had completed high school and percentage of adults who had completed college), and occupation variables (percentage of persons in executive, managerial, or professional specialty jobs).

The researchers found an association between neighborhood socioeconomic scores and residents’ likelihood of developing heart disease. People living in the most disadvantaged areas—those neighborhoods with the lowest socioeconomic scores—had a greater risk of developing heart disease than people living in the most advantaged neighborhoods.

The researchers report that living in the most disadvantaged group of neighborhoods, as compared with the most advantaged group, was associated with a 70 to 90 percent higher risk of coronary disease in whites and a 30 to 50 percent higher risk in blacks.

"In other words," Chambless says, "persons at similar levels of individual family income, educational level, and occupational level are still differentiated with respect to health status by the socioeconomic level of their neighborhoods."

Why? Chambless says the researchers aren’t sure, but they speculate that differences between neighborhoods with respect to factors such as tobacco advertising, the availability of healthful foods, and even residents’ perceived safety and stress levels could all contribute to the development of risk factors for heart disease.

A report on the study appeared in the July 12, 2001 issue of the New England Journal of Medicine. The study was funded by the National Heart, Lung and Blood Institute.