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Neighbourhood characteristics and health outcomes: evaluating the association between socioeconomic status, tobacco store density and health outcomes in Baltimore City
  1. Panagis Galiatsatos1,2,3,
  2. Cynthia Kineza4,
  3. Seungyoun Hwang2,
  4. Juliana Pietri3,
  5. Emily Brigham2,
  6. Nirupama Putcha2,
  7. Cynthia S Rand2,
  8. Meredith McCormack2,
  9. Nadia N Hansel2
  1. 1 Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland, USA
  2. 2 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  3. 3 Medicine for the Greater Good, Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA
  4. 4 Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to Dr Panagis Galiatsatos, Johns Hopkins University, Pulmonary and Critical Care Medicine, Baltimore, MD 212, USA; panagis{at}


Introduction Several studies suggest that the health of an individual is influenced by the socioeconomic status (SES) of the community in which he or she lives. This analysis seeks to understand the relationship between SES, tobacco store density and health outcomes at the neighbourhood level in a large urban community.

Methods Data from the 55 neighbourhoods of Baltimore City were reviewed and parametric tests compared demographics and health outcomes for low-income and high-income neighbourhoods, defined by the 50th percentile in median household income. Summary statistics are expressed as median. Tobacco store density was evaluated as both an outcome and a predictor. Association between tobacco store densities and health outcomes was determined using Moran’s I and spatial regression analyses to account for autocorrelation.

Results Compared with higher-income neighbourhoods, lower-income neighbourhoods had higher tobacco store densities (30.5 vs 16.5 stores per 10 000 persons, P=0.01), lower life expectancy (68.5 vs 74.9 years, P<0.001) and higher age-adjusted mortality (130.8 vs 102.1 deaths per 10 000 persons, P<0.001), even when controlling for other store densities, median household income, race, education status and age of residents.

Conclusion In Baltimore City, median household income is inversely associated with tobacco store density, indicating poorer neighbourhoods in Baltimore City have greater accessibility to tobacco. Additionally, tobacco store density was linked to lower life expectancy, which underscores the necessity for interventions to reduce tobacco store densities.

  • advocacy
  • disparities
  • priority/special populations
  • socioeconomic status

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  • Contributors All authors contributed to the writing of this manuscript. PG and NH prepared the concept, writing and review of the preliminary manuscripts. CR, MM, EB and NP all contributed in reviewing the data and discussing of the conclusions. PG, CK, SH and JP prepared and analysed the data.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Our data are drawn from the Baltimore City Health Department. Data may be made available upon request via email.