gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Association of neighbourhood socioeconomic status and individual socioeconomic status cardiovascular risk factors in an eastern German population – the CARLA study 2002-2006

Meeting Abstract

  • Karin Halina Greiser - Deutsches Krebsforschungszentrum (DKFZ), Heidelberg
  • Daniel Tiller - Institut für Med. Epidemiologie, Biometrie und Informatik, MLU Halle-Wittenberg, Halle (Saale)
  • Oliver Kuss - Institut für Med. Epidemiologie, Biometrie und Informatik, MLU Halle-Wittenberg, Halle (Saale)
  • Alexander Kluttig - Institut für Med. Epidemiologie, Biometrie und Informatik, MLU Halle-Wittenberg, Halle (Saale)
  • Gavin Rudge - Public Health, Epidemiology and Biostatistics Unit, The College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK
  • Barbara Schumann - 4 Centre for Global Health Research, Umeå University, Umeå, Sweden
  • Karl Werdan - Universitätklinik für Innere Medizin III, MLU Halle-Wittenberg, Halle (Saale)
  • Johannes Haerting - Institut für Med. Epidemiologie, Biometrie und Informatik, MLU Halle-Wittenberg, Halle (Saale)

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds168

doi: 10.3205/11gmds168, urn:nbn:de:0183-11gmds1686

Veröffentlicht: 20. September 2011

© 2011 Greiser et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Background/objectives: Individual socioeconomic status (SES) is a determinant of cardiovascular risk factors (RF). Recent studies suggest an independent association of neighbourhood SES with cardiovascular RF, but the mechanisms have not fully been understood. Our aim was to assess the association of neighbourhood and individual SES with cardiovascular RF in an Eastern German population.

Methods: We used cross-sectional data of 1779 participants aged 45-83 years of the population-based CARLA study. We calculated linear mixed models to assess the age-adjusted influence of neighbourhood-specific unemployment rates and individual SES on smoking, systolic blood pressure (SBP), and body mass index (BMI). Spatial dependencies within and between neighbourhoods were adjusted for by using ICAR models.

Results: Neighbourhood-specific unemployment rates varied between 6.3 and 35.3%. Per 1% increase in the neighbourhood’s unemployment rate, the number of cigarettes smoked/day increased by 0.11 in men (95% confidence interval, CI=0.09; 0.12) and 0.05, (CI=0.04; 0.07) in women.

In women, SBP increased by 0.04 mmHg with unemployment rate (CI=0.03; 0.06), while there was no statistically significant association of SBP with SES in men.

BMI was only in women significantly associated with unemployment (increase in BMI per 1% increase in unemployment rate 0.04 (CI=0. 02; 0.05)).

Associations of RF with individual SES were stronger than with neighbourhood SES in multiple models.

Conclusions: Our findings confirm the previously described association of neighbourhood SES with smoking independent of individual SES, while we found inconsistent associations with SBP and BMI. The neighbourhood environment may be more relevant for behavioural than for biomedical risk factors.


Auchincloss AH, Diez Roux AV, Brown DG, Erdmann CA, Bertoni AG. Neighborhood resources for physical activity and healthy foods and their association with insulin resistance. Epidemiology. 2008;19(1):146-57.
Auchincloss AH, Diez Roux AV, Mujahid MS, Shen M, Bertoni AG, Carnethon MR. Neighborhood resources for physical activity and healthy foods and incidence of type 2 diabetes mellitus: the Multi-Ethnic study of Atherosclerosis. Arch Intern Med. 2009;169(18):1698-704.
Borrell LN, Diez Roux AV, Rose K, Catellier D, Clark BL; Atherosclerosis Risk in Communities Study. Neighbourhood characteristics and mortality in the Atherosclerosis Risk in Communities Study. Int J Epidemiol. 2004;33(2):398-407.
Chichlowska KL, Rose KM, Diez-Roux AV, Golden SH, McNeill AM, Heiss G. Individual and neighborhood socioeconomic status characteristics and prevalence of metabolic syndrome: the Atherosclerosis Risk in Communities (ARIC) Study. Psychosom Med. 2008;70(9):986-92. Epub 2008 Sep 16.
Diez Roux AV, Merkin SS, Arnett D, Chambless L, Massing M, Nieto FJ, Sorlie P, Szklo M, Tyroler HA, Watson RL. Neighborhood of residence and incidence of coronary heart disease. N Engl J Med. 2001;345(2):99-106.
Diez Roux AV. Neighborhoods and health: where are we and were do we go from here? Rev Epidemiol Sante Publique. 2007;55(1):13-21.
Dragano N, Bobak M, Wege N, Peasey A, Verde PE, Kubinova R, Weyers S, Moebus S, Möhlenkamp S, Stang A, Erbel R, Jöckel KH, Siegrist J, Pikhart H. Neighbourhood socioeconomic status and cardiovascular risk factors: a multilevel analysis of nine cities in the Czech Republic and Germany.
Kim D, Diez Roux AV, Kiefe CI, Kawachi I, Liu K. Do neighborhood socioeconomic deprivation and low social cohesion predict coronary calcification?: the CARDIA study. Am J Epidemiol. 2010;172(3):288-98. Epub 2010 Jul 7.
Marmot M, Wilkinson RG. Social determinants of health. Oxford: Oxford University Press; 2003.
Mujahid MS, Diez Roux AV, Morenoff JD, Raghunathan TE, Cooper RS, Ni H, Shea S. Neighborhood characteristics and hypertension. Epidemiology. 2008;19(4):590-8.
Murray ET, Diez Roux AV, Carnethon M, Lutsey PL, Ni H, O'Meara ES. Trajectories of neighborhood poverty and associations with subclinical atherosclerosis and associated risk factors: the multi-ethnic study of atherosclerosis. Am J Epidemiol. 2010;171(10):1099-108. Epub 2010 Apr 27.
Nocon M, Keil T, Willich S. Education, income, occupational status and health risk behaviour. Journal of Public Health. 2007;15: 401-405.
Skalická V, van Lenthe FJ, Bambra C, Krokstad S, Mackenbach J. Material, psychosocial, behavioural and biomedical factors in the explanation of relative socio-economic inequalities in mortality: evidence from the HUNT stuffy. Int J Epidemiol. 2009;38:1272-1284.
Stringhini S, Sabia S, Shipley M, Brunner E, Nabi H, Kivimaki M, Singh-Manoux A. Association of socioeconomic position with health behaviors and mortality. The Whitehall 2 study. JAMA. 2010;303(12):1159-1166.