# Area-level Socio-economic Conditions and Individual-level Health and Mortality: Exploring Place-Based Mechanisms and Individual-level Psychosocial Processes

> **NIH NIH R01** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2024 · $548,883

## Abstract

PROJECT SUMMARY
More than 1 million drug overdose deaths have occurred in the US since 1999, while progress in reducing
mortality from cardiovascular disease and diabetes has stalled since 2010. This evidence of rising morbidity
and mortality in midlife has drawn attention to health risks among the working-age population. Increasing
geographic variation in premature mortality, most pronounced during early to mid-adulthood, highlights the role
of place. Research is needed that systematically identifies how place-based features contribute to the US
midlife health and mortality crisis. Drawing from socio-ecological perspectives of health, the present study will
test a comprehensive conceptual framework to examine the direct, indirect, and moderating effects within the
place and health relationship. We will use two unique datasets that allow us to address limitations that have
stymied past efforts. First, the Midlife in the United States study (MIDUS) enrolled 7,108 adults in the
contiguous US aged 25 to 74 in 1995-1996 and surveyed them again in 2004-2006 and in 2013-2014, adding
a sample of 592 Black adults in 2004-2006 who were surveyed again in 2016-2017. Second, the Utah
Population Database (UPDB) includes data from a variety of state vital and administrative records for over 12
million individuals over 100 years, linked by family and containing geocoded residential addresses. From the
UPDB, we will create a sample of 1.6 million adults aged 25 to 74 residing in a four-county urban area in 2000,
for whom mortality is tracked until 2020 with 142,330 deaths recorded. Both datasets enable place-based
longitudinal health research.
In examining the health outcomes of substance misuse, mental health, cardiometabolic health, and mortality,
we will: identify the prospective effects of area-level socioeconomic conditions on individual-level health and
mortality outcomes (Aim 1); and document the prospective effects of place-based built, social, and natural
environments on individual-level health and mortality outcomes (Aim 2). Attention will be given to how
environmental features moderate and mediate prospective effects of area-level socioeconomic conditions, and
to the individual-level mediating processes. We will use innovative methods to measure a range of place-based
features and improve estimation using rigorous statistical methods (e.g., multi-level structural equation
modeling, spatial analysis, and advanced survival analysis). Through this comprehensive investigation, we will
document how place-based factors drive midlife health and mortality disparities and provide valuable insights
into the complex and dynamic relationships within systems of people and places. This holistic research effort
will produce novel evidence to support the development of effective place-based interventions.

## Key facts

- **NIH application ID:** 10754278
- **Project number:** 5R01AG080440-02
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** David Stuart Curtis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $548,883
- **Award type:** 5
- **Project period:** 2023-01-01 → 2027-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10754278

## Citation

> US National Institutes of Health, RePORTER application 10754278, Area-level Socio-economic Conditions and Individual-level Health and Mortality: Exploring Place-Based Mechanisms and Individual-level Psychosocial Processes (5R01AG080440-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10754278. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*