It’s hardly a surprise that people living in poor neighborhoods suffer earlier death than their wealthier neighbors. And sure enough, a new study has confirmed that residents of poor neighborhoods have higher levels of obesity and worse overall health than those living on the ritzy side of the tracks. The study reviewed lifestyle, diet and medical history data collected in 1995-96 from 565,697 people aged 50 to 71 living in six states and two metropolitan areas. Predictably, the research found that the poorer the neighborhood, the greater the likelihood of early death.
The obvious conclusion is that economically deprived people eat badly, don’t exercise, get fat, and then get sick and die — but that’s not what the study found! Instead, the researchers discovered that even after controlling for smoking, diet, exercise, and medical factors, poor people died younger than those living in more economically robust neighborhoods. The risk factor was rather dramatic, with those living in the most deprived neighborhoods carrying a 22 percent higher risk of dying even after adjusting for diet and lifestyle.
“We were expecting that once we controlled for these lifestyle and medical risk factors, the differences would go away,” said study director Dr. Chyke Doubeni of the University of Massachusetts Medical School. “We weren’t surprised by the unadjusted differences, but we were surprised that the differences persisted after controlling for lifestyle factors such as smoking, diet, exercise and medical risks.”
So if it isn’t a diet of Mickey D’s and macaroni cutting short the life expectancy in slums, if it isn’t the lack of a gym membership, then what is it? For one, a rather obvious thing, stress in the worst neighborhoods certainly exerts a toll. Poor neighborhoods, particularly in cities, tend to be less safe, more crowded, noisier, and uglier — all stress factors. And also, the stress of not having enough money certainly wears on people. No matter how well you eat and how much you exercise, if you’re overwhelmed by stress, your health will suffer.
Then there’s the fact that poor neighborhoods tend to have substandard housing that can be rife with mold, insect infestations, and toxic building materials such as lead paint. Traffic often is worse and industrial buildings may be in the area — at least in cities — exposing residents to higher levels of pollution. Poor neighborhoods have more convenience stores and fewer supermarkets, and studies have found that such a configuration typically leads to more obesity and smoking — although, to be sure, obesity and smoking were factored out of the study results. But the consequences of forcing people to consume more prepackaged, processed foods and fewer antioxidant rich fresh fruits and vegetables was not. In addition, studies have found that neighborhoods with the most fast food restaurants have a 13 percent higher stroke rate than neighborhoods with the least. That fact may have to do with the residents eating too many Big Macs, but it may also have to do with cooking emissions and the traffic generated by such joints. There’s also typically more exposure to drugs in poor neighborhoods; I’ve written before about the negative health consequences of living near “crack houses.” And, of course, there’s more crime and less access to quality health care in the poorest locations.
Of course, many poor neighborhoods are in remote rural areas, where many of the above factors don’t apply, but then the chances increase of homes being built near toxic dumps or on byways used for transporting toxic materials. Water quality tends to be abysmal and unregulated, and if the area has farming, insecticide and pesticide spraying may be a factor.
A study conducted by Harvard University found startling disparities in lifespan depending on where people lived. While Asian-American women living in the wealthy suburbs around Bergen County, N.J., typically live to age 91, American Indian men living in the poverty-struck reservations of South Dakota live to an average age of 58. Urban blacks have an average lifespan of 71 (both sexes combined) compared to 78 years for middle Americans.
But moving poor people en masse to rich neighborhoods won’t help. Yet another study, this one by Stanford University in 2006, found that poor people living in rich neighborhoods fared the worst of all. The research followed 8200 low-income individuals over a 17-year period and found that 19 out of every 1000 subjects living in rich neighborhoods had died, compared to only 11 of every 1,000 who remained in poorer neighborhoods. As with Dr. Doubeni’s study, the researchers controlled for risk factors including age, obesity, hypertension, and smoking. The researchers suspected that those in wealthy towns had less disposable income left over for medical care and essential services because of the high cost-of-living. They also acknowledge that stress may play a big role.
“You look out every day and you’re at the bottom of the social ladder,” said Dr. Catherine Catherine Cubbin, of Stanford. It seems that the stress of being poor kills no matter where a person resides. But poor people in rich neighborhoods may have to deal with social isolation plus the added strain of having and doing less than those around them. They might have fewer friends than when they lived in the ‘hood’, and as I just wrote, loneliness does little for the lifespan.
Certainly, even if you’re strapped financially, it helps to pay attention to diet and lifestyle factors. It also helps, if possible, to move out of the poorest neighborhoods. You don’t have to move into the swanky part of town — just an area one notch better will help. In fact, just moving closer to any kind of green area, even if it’s just a small neighborhood park, will help. Do your research to find such places. They do exist. In fact, in the above-mentioned Harvard study of geography and lifespan, those poor people residing in rural areas of the northern Plains states outlived the average middle-income American by a full year.
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