A Neighborhood Wealth Metric for Use in Health Studies

BackgroundMeasures of neighborhood deprivation used in health research are typically based on conventional area-based SES.PurposeThe aim of this study is to examine new data and measures of SES for use in health research. Specifically, assessed property values are introduced as a new individual-level metric of wealth and tested for their ability to substitute for conventional area-based SES as measures of neighborhood deprivation.MethodsThe analysis was conducted in 2010 using data from 1922 participants in the 2008–2009 survey of the Seattle Obesity Study (SOS). It compared the relative strength of the association between the individual-level neighborhood wealth metric (assessed property values) and area-level SES measures (including education, income, and percentage above poverty as single variables, and as the composite Singh index) on the binary outcome fair/poor general health status. Analyses were adjusted for gender, categoric age, race, employment status, home ownership, and household income.ResultsThe neighborhood wealth measure was more predictive of fair/poor health status than area-level SES measures, calculated either as single variables or as indices (lower DIC measures for all models). The odds of having a fair/poor health status decreased by 0.85 (95% CI=0.77, 0.93) per $50,000 increase in neighborhood property values after adjusting for individual-level SES measures.ConclusionsThe proposed individual-level metric of neighborhood wealth, if replicated in other areas, could replace area-based SES measures, thus simplifying analyses of contextual effects on health.