Neighborhood Socioeconomic Deprivation in Young Adulthood and Future Respiratory Health: The CARDIA Lung Study.

Abstract Purpose : There are limited data on the relationship between neighborhood level factors and their association with lung health independent of individual socioeconomic status. We soughto determine whether baseline neighborhood level socioeconomic deprivation in young adults is associated with greater 20-year decline in lung function and higher risk of future lung disease, independent of baseline individual income, education, and smoking status. Methods : This multi-center population-based cohort study included 2689 CARDIA participants for whom neighborhood deprivation was determined at year 10 (baseline for study) and who had complete lung function measurements at years 10 and 30. Baseline neighborhood deprivation was defined using 1990 Census blocks as a combination of four factors involving median household income, poverty level, and educational achievement. The outcomes were decline in lung function over 20 years (year 10 to 30) and odds of emphysema (year 25). Results : In multivariable regression models, greater baseline neighborhood deprivation was associated with greater decline in lung function (-2.34 mL/year excess annual decline in FEV1 in the highest versus lowest deprivation quartile (p=0.014)). Furthermore, baseline neighborhood deprivation was independently associated with greater odds of emphysema (OR 2.99, 95% CI 1.42-6.30). Conclusions : Residence in neighborhoods with greater socioeconomic deprivation in young adulthood, independent of individual income and smoking, is associated with greater 20-year decline in FEV1 and higher risk of future emphysema.