Poor People in Wealthy Areas Die at Higher Rate, Study Finds
Poor people who live in well-to-do neighborhoods were found to have higher death rates than their counterparts who live in poorer neighborhoods, according to a new study by Stanford University School of Medicine researchers that will be published in the December issue of the American Journal of Public Health.
“We tend to assume that people living in a high socioeconomic status neighborhood are well off,” said Marilyn Winkleby, PhD, an associate professor of medicine at the Stanford Prevention Research Center and the lead author of the study.
To their surprise, that’s not what the researchers found. After 17 years, 19 out of every 1,000 women of low socioeconomic status who lived in wealthier neighborhoods had died, compared with 11 out of every 1,000 from poorer neighborhoods. The trend was similar in men, but less dramatic.
Looking for what is causing the difference, researchers were able to discount risk factors such as obesity, hypertension and smoking; and access to neighborhood goods and services, such as health care, grocery stores, parks and gyms. There were also no significant differences in the causes of death, which were largely from chronic diseases, the researchers said.
Winkleby suggested two explanations for the discrepancy. First, the cost of living in an affluent neighborhood could leave poor people with little disposable income to spend on essential goods and services, such as health care and healthy food, and less time to take advantage of the social services and health care often concentrated in low-income neighborhoods.
Second is the possibility that poorer people in higher-income neighborhoods fare worse for psychological and social reasons.
A discrepancy in a person’s social position relative to others may have an effect on a person’s health, said Winkleby. “You look out every day and you’re at the bottom of the social ladder,” she said.
The researchers caution that their study should not be interpreted as meaning that poor people are necessarily better off living in low-income neighborhoods. “There could be other benefits” from living in a wealthier neighborhood, said co-author Catherine Cubbin, PhD. “We don’t want to imply that poor people should move to poor neighborhoods, where there continues to be great need.”
Also, the study highlights the needs of a population that may be overlooked and underserved by government agencies and health workers.
“There’s a group of people really at risk that we’re not even thinking about,” said Cubbin.
The research was funded by a grant from the National Institutes of Health.