@article {657, title = {Area characteristics and individual-level socioeconomic position indicators in three population-based epidemiologic studies.}, journal = {Ann Epidemiol}, volume = {11}, year = {2001}, month = {2001 Aug}, pages = {395-405}, abstract = {

PURPOSE: There is growing interest in incorporating area indicators into epidemiologic analyses. Using data from the 1990 U.S. Census linked to individual-level data from three epidemiologic studies, we investigated how different area indicators are interrelated, how measures for different sized areas compare, and the relation between area and individual-level social position indicators.

METHODS: The interrelations between 13 area indicators of wealth/income, education, occupation, and other socioenvironmental characteristics were investigated using correlation coefficients and factor analyses. The extent to which block-group measures provide information distinct from census tract measures was investigated using intraclass correlation coefficients. Loglinear models were used to investigate associations between area and individual-level indicators.

RESULTS: Correlations between area measures were generally in the 0.5--0.8 range. In factor analyses, six indicators of income/wealth, education, and occupation loaded on one factor in most geographic sites. Correlations between block-group and census tract measures were high (correlation coefficients 0.85--0.96). Most of the variability in block-group indicators was between census tracts (intraclass correlation coefficients 0.72--0.92). Although individual-level and area indicators were associated, there was evidence of important heterogeneity in area of residence within individual-level income or education categories. The strength of the association between individual and area measures was similar in the three studies and in whites and blacks, but blacks were much more likely to live in more disadvantaged areas than whites.

CONCLUSIONS: Area measures of wealth/income, education, and occupation are moderately to highly correlated. Differences between using census tract or block-group measures in contextual investigations are likely to be relatively small. Area and individual-level indicators are far from perfectly correlated and provide complementary information on living circumstances. Differences in the residential environments of blacks and whites may need to be taken into account in interpreting race differences in epidemiologic studies.

}, keywords = {Adult, Black or African American, Cardiovascular Diseases, Demography, Educational Status, Factor Analysis, Statistical, Humans, Income, Linear Models, Occupations, Risk Factors, Social Class, Social Environment, Socioeconomic Factors, Statistics, Nonparametric, United States, White People}, issn = {1047-2797}, doi = {10.1016/s1047-2797(01)00221-6}, author = {Diez-Roux, A V and Kiefe, C I and Jacobs, D R and Haan, M and Jackson, S A and Nieto, F J and Paton, C C and Schulz, R} } @article {668, title = {Incidence and predictors of coronary heart disease among older African Americans--the Cardiovascular Health Study.}, journal = {J Natl Med Assoc}, volume = {93}, year = {2001}, month = {2001 Nov}, pages = {423-9}, abstract = {

Although coronary heart disease (CHD) is the leading cause of death and morbidity in older African Americans, relatively little is known about the incidence and predictors of CHD in this population. This study was undertaken to determine the incidence and predictors of CHD in African-American men and women aged 65 years and older. The participants in this study included a total of 924 African-American men and women aged 65 years of age and older who participated in the Cardiovascular Health Study (CHS). The overall CHD incidence was 26.6 per 1,000 person-years of risk. Rates were higher in men than women (35.3 vs. 21.6) and in those 75 years or older than in those less than 75 years (31.3 vs. 24.5). In multivariate analysis, factors associated with higher risk of incident disease were male gender [relative risk (RR) = 1.8, 95\% confidence interval (CI) = 1.1, 2.7], diabetes mellitus (RR = 1.9, 95\% CI = 1.2, 2.9), total cholesterol (RR for 40 mg/dL increment = 1.3, 95\% CI = 1.0, 1.5), and low (i.e., <0.9) ankle-arm index (RR = 2.1, 95\% CI = 1.3, 3.4) after adjusting for age. Within this cohort of older African Americans, male gender, diabetes mellitus, total cholesterol, and low ankle-arm index and were independently predictive of incident events. These results suggest that the ankle-arm index, a measure of advanced atherosclerosis, should be further evaluated for its efficacy in identifying older African Americans at risk for incident clinical events.

}, keywords = {Age Distribution, Aged, Black or African American, Coronary Disease, Female, Health Status, Humans, Incidence, Male, Predictive Value of Tests}, issn = {0027-9684}, author = {Jackson, S A and Burke, G L and Thach, C and Cushman, M and Ives, D and Powe, N and Manolio, T A} }