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Title: The Possible Effect of Increasing Neighborhood Education and Income on Overweight/Obesity, Type 2 Diabetes, and Smoking in San Fransisco Adults
Citation Type: Conference Paper
Publication Year: 2013
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Abstract: We employ propensity score matching (PSM) to minimize structural confounding and improve causal inference in an observational neighborhood effects study. We approximate a real-world scenario by creating causal contrasts where those in a higher socioeconomic status (SES) neighborhood quartile are matched with those in the next lower quartile. Typically studies split a sample into one exposed group and one unexposed group, or compare all lower groups to a single high group (or vice versa). Our approach yields more realistic policy estimates. We estimate the average effect of the treatment on the treated (ATT) moving from a lower to the next higher SES neighborhood quartile on overweight/obesity, type 2 diabetes, and smoking. Neighborhood SES is classified into quartiles of census-tract level median household income (NH income) and percent with bachelors degree or higher (NH education). Individual-level covariate and outcome data from the 2005, 2007, and 2009 California Health Interview Survey (CHIS) for San Francisco adults (n=2,515) was linked with census-tract level SES data from the American Community Survey (2006-2010). PSM results suggest a significant difference in ATT only when moving from the moderate-high to high NH education quartile for overweight/obesity (-0.10, 95% CI: -0.20 to -0.03) and smoking (-0.05, 95% CI: -0.12 to -0.03), using exchangeable exposure groups. We failed to find evidence of an effect for other comparisons using NH education. All comparisons using NH income were non-significant with estimates close to zero. The assumptions of observational neighborhood effects studies limit our ability to identify causal effects, but this study addresses some key challenges by using propensity score matching with policy-relevant causal contrasts.
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Authors: McDonald, Kelsey N.; Oakes, J.Michael
Conference Name: 2013 Annual Meeting of the Society for Epidemiologic Research
Publisher Location: Boston, MA
Data Collections: IPUMS NHGIS
Topics: Health, Housing and Segregation
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