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Related Experiment Videos

ZIP-code-based versus tract-based income measures as long-term risk-adjusted mortality predictors.

Avis J Thomas1, Lynn E Eberly, George Davey Smith

  • 1Coordinating Centers for Biometric Research, Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55414, USA. avist@ccbr.umn.edu

American Journal of Epidemiology
|August 9, 2006
PubMed
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Socioeconomic position strongly influences mortality. This study compared U.S. Census tract and ZIP code income measures, finding both predict mortality, with tract-based income showing slightly greater predictive power for overall mortality risk.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Disparities

Background:

  • Socioeconomic position (SEP) is a well-established determinant of mortality.
  • Area-based measures are often used to assess SEP's impact when individual data is unavailable.
  • Limited data exists comparing U.S. Census tracts versus ZIP codes for SEP assessment.

Purpose of the Study:

  • To compare the relative merits of U.S. Census tract-based versus ZIP code-based median household income as predictors of mortality.
  • To evaluate the independent predictive value of these area-based SEP measures in a large cohort.

Main Methods:

  • Analysis of 293,138 middle-aged men from the Multiple Risk Factor Intervention Trial (1973-1975) with 25-year mortality follow-up.
  • Risk-adjusted proportional hazards models were used to assess mortality risk associated with income levels.

Related Experiment Videos

  • Comparison of models including ZIP-code-based income, tract-based income, or both.

    • Main Results:

    • Both ZIP-code-based and tract-based median household income were significant predictors of all-cause mortality.
    • A $10,000 decrease in income was associated with a 16% increased hazard for ZIP-code income and a 15% increased hazard for tract income.
    • Tract-based income demonstrated slightly stronger predictive power in a combined model (HR=1.11) compared to ZIP-code-based income (HR=1.05).

    Conclusions:

    • Both U.S. Census tract and ZIP code median household income are valuable area-based measures for estimating socioeconomic position's effect on mortality.
    • Tract-based income may offer a slightly more robust prediction of mortality risk.
    • These findings support the use of area-based socioeconomic measures in public health mortality analyses.