Neighborhood Socioeconomic Status and Diverse Health-related Outcomes among American Indian and Alaska Native Peoples during the COVID-19 Pandemic
摘要
Health inequities are influenced by social determinants at both individual and neighborhood levels. The literature is limited with respect to neighborhood-level socioeconomic inequalities and health-related outcomes among American Indian and/or Alaska Native (AI/AN) people in the US.
MethodsWe surveyed 907 AI/AN people aged 18 years and older seen at five organizations. Socioeconomic characteristics of neighborhoods were quantified using the area deprivation index, with the top 30% of scores classified as more deprived. Multivariable linear regressions were applied to examine the associations between area deprivation index and general and mental health, food insecurity, perceived stress, social support, resilience, and coping strategies controlling for age, gender, and educational attainment.
ResultsApproximately 15% of participants lived in more deprived ZIP codes. Compared to participants in less deprived areas, those living in more deprived ZIP codes had significantly poorer physical health (mean = -2.20, SE = 1.04, p = 0.03) and resilience (mean = -0.18, SE = 0.07, p = 0.02) and significantly higher food insecurity (mean = 0.63, SE = 0.24, p = 0.01), perceived stress (mean = 0.75, SE = 0.36, p = 0.04), and avoidance coping strategies (mean = 0.12, SE = 0.05, p = 0.02). No significant associations were observed between area deprivation index and mental health, social support, or problem solving coping strategies.
ConclusionThis study highlights significant associations between area deprivation and five of the eight measures of physical, mental, and social health and well-being among AI/AN people. The findings underscore the importance of developing and implementing strategies to reduce socioeconomic inequalities in deprived areas.