Individual, household and neighborhood socioeconomic status and mortality: a study of absolute and relative deprivation

Our objectives were twofold (1) to examine the effects of neighborhood socioeconomic status (SES) on mortality by gender and age and (2) to assess the impact of individual's household SES relative to one's neighborhood on mortality. Data were taken from the Israel Longitudinal Mortality Study, which linked a 20% sample of the 1983 census to mortality records through 1992. Multilevel modeling was performed on 131,156 men and women aged 45-89 years living in approximately 880 neighborhoods. Overall, 27,334 deaths were reported during the 9.5 year study period. Independent of individual characteristics, mortality risks increased 1-2% (p<0.05) per unit increase in area deprivation. Results did not vary by age or gender. Household deprivation relative to that of one's neighborhood and adjusted for absolute SES affected mortality in men only. Specifically, men living in relative disadvantage to their neighbors had lower risks of mortality than those living in concordance with their area (OR 0.86, 95% CI 0.80-0.92).