We examined the relationship between neighborhood socioeconomic context and self-reported health among low-income, rural women aged 50+ years, without a history of breast cancer. Tract-level census data were linked to individual level data from the baseline survey of a community trial to increase breast cancer screening rates. Generalized estimating equations were used to analyze data for 1988 women and 56 census tracts. Neighborhood poverty was associated with a greater likelihood of poor self-reported health, adjusted for age, race and socioeconomic status (OR=1.35, 95% CI=1.08-1.68). This effect was greatest for individuals with incomes below the median neighborhood income.