Social
Assessing the Relationship Between Place-Based Economic Connectedness and Health in the United States Stephen Uong* Stephen Uong Nadav Sprague Katherine Keyes Andrew Rundle
Introduction
Economic connectedness, connections between people of different socioeconomic status, is related to higher economic mobility but its relationship with health is uncertain. In a US-nationwide analysis, we aim to assess our hypothesis that economic connectedness is protective against adverse health outcomes and positively associated with preventive service utilization, with stronger associations in areas experiencing more poverty.
Methods
We merged zip code tabulation area (ZCTA)-level data from the Social Capital Atlas (economic connectedness), CDC PLACES 2023 release (health indicators), US Census American Community Survey 2014-2018 estimates (sociodemographics). Economic connectedness was defined as the share of high-SES friends among low-SES people (72.2 million Facebook users aged 25-44 active within last 30 days from May 28, 2022). Across 18,074 ZCTAs, we fit adjusted linear models to determine the association between economic connectedness with A) 5 adverse health indicators: no insurance access, poor health status, health diagnosis/condition, disability, health behavior and B) preventive service utilization. We further stratified models by poverty, <5%, 5-20%, and >20% (% households with incomes lower than the federal poverty level) and assessed whether hypotheses were met (p-association < 0.05).
Results
Overall, 89% (n=33) of models showed protective associations for adverse health outcomes and positive associations for preventive service utilization. In poverty-stratified analyses, 76% (n=28) of models had stronger associations with higher poverty (>20% vs. <5%).
Conclusion
Our findings suggest that economic connectedness is beneficial for health, especially in high poverty areas. This emphasizes the potential of community-level interventions, such as designing public library programs and parks to foster cross-class interactions and friendships, to contribute to improved community health.
