Neighborhood Social Context and Racial Differences in Women's Heart Disease Mortality

• Published in: Journal of health and social behavior Vol. 39; no. 2; pp. 91 - 107
• Main Authors: Leclere, Felicia B., Rogers, Richard G., Peters, Kimberley
• Format: Journal Article
• Language: English
• Published: Washington, DC American Sociological Association 01-06-1998
• Subjects: Adolescent; Adult; African Americans; Aged; Attrition (Research Studies); Biological and medical sciences; Black people; Black White Differences; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular diseases; Census; Census tracts; Community Relations; Coronary heart disease; Death; Demographic Characteristics; Drug Use; Empowerment; European Continental Ancestry Group; Exercise; Factors; Female; Female headed; Female Headed Households; Females; Ghettos; Health Surveys; Heart; Heart Diseases; Heart Diseases - ethnology; Heart Diseases - mortality; Heart Disorders; Households; Humans; Individual Characteristics; Land Use; Medical sciences; Middle Aged; Morbidity; Mortality; Mortality Rate; Mortality Rates; National Surveys; Neighborhoods; Obesity; One Parent Family; Population; Poverty; Proportional Hazards Models; Racial Differences; Racial Discrimination; Racial Segregation; Residential Patterns; Risk Factors; Social Behavior; Social Environment; Social Networks; Socioeconomic Factors; Socioeconomics; United States of America; USA; White people; Whites; Women; Womens health; USA; United States > US; Social environment; Human; Social isolation; Mortality; Risk factor; Race; Negroid; Cardiovascular disease; Female; Black American; Caucasoid; Coronary heart disease; Americas; Head Of Household > women; Residence Characteristics; Differential Mortality; United States; Biology; North America; Ethnic Groups; Population Characteristics; Population; Demographic Factors; Spatial Distribution; Cultural Background; Households; Risk Factors; Causes Of Death; Diseases; Neighborhood; Geographic Factors; Northern America; Developed Countries; Heart Diseases > women; Family And Household; Population Dynamics
• ISSN: 0022-1465; 2150-6000
• DOI: 10.2307/2676393

Compared to white women, black women experience similar rates of heart disease morbidity, but higher rates of heart disease mortality. This puzzling relationship may be due to several factors working at varied levels to affect each race. For example, the high heart disease mortality rate may be due to individual health or socioeconomic risk factors or to social structural factors. We conduct a multi-level analysis to address these issues, using data from a newly released data file that links the National Health Interview Survey with death certificate information from the National Death Index, and with additional community level data from the 1990 Census STF-3A files. We are primarily interested in the effects of female-headship rates in the census tracts on coronary heart disease mortality (CHD) among black and white women. We find that women who live in communities with high concentrations of female-headed families are more likely to die of heart disease, net of other characteristics. For younger women, the effect appears to be routed primarily through poverty whereas for older women the effect of female-headship rates remains, net of other census tract characteristics. This study, then, highlights the importance of examining the effect of neighborhoods and their social content on mortality.