The Association of Early Life State, Work Context and Neighborhood Context with Hypertension, Diabetes and Ischemic Heart Disease

David H. Rehkopf, Stanford University
Mark Cullen, Stanford University

In the majority of studies on context and health, the focus, primarily due to data limitations, has been on a single type of context, most commonly neighborhood. Yet in addition to neighborhood of residence, the alternative environment of extensive exposure is the workplace. We use a unique data linkage to combine data on early life state of residence, work environment, and neighborhood environment for blue and white collar workers that were followed from 1996 to 2012, with 305,936 person-years of observation. Disease was assessed using medical claims. In our initial analyses we find small but statistically significant associations between early state of residence characteristics and later life hypertension, diabetes and ischemic heart disease. The most consistent associations were with income inequality and percent white. Our next analyses will examine trajectories from early life state to workplace and neighborhood, and the relative strength with which each predicts chronic disease outcomes.