California Center for Population Research

Objective: To examine the contextual effects of urban neighborhood characteristics on all-cause mortality among adults aged 70 years and older. Methods: Survey data are from the Study of Assets and Health Dynamics Among the Oldest Old (AHEAD), a 1993 U.S. national probability sample of noninstitutionalized persons born in 1923 or earlier. Death is assessed between the baseline assessment (1993) and the first follow-up interview (1995). Neighborhood data are from the 1990 Census. Hierarchical logistic regression is used to estimate multilevel models. Results: In multilevel models, the effects of neighborhood-level socioeconomic disadvantage were not significantly associated with 2-year all-cause mortality, net of individuallevel variables. The log odds of dying between the two time points are higher in high proportion Hispanic neighborhoods, net of individual-level socio-demographic variables, but this effect is partly mediated by individual-level health variables. The log odds of dying are significantly (p < 0.05) lower in affluent neighborhoods, controlling for all individual-level variables, including potential health mediators, and controlling for proportion Hispanic. Discussion: There are survival-related benefits of living in an affluent urban neighborhood, which we posit may be manifest through the diffusion of innovations in health care and health promotion activities in these areas.