House J S, Lepkowski J M, Williams D R, Mero R P, Lantz P M, Robert S A, Chen J
Survey Research Center, University of Michigan, Ann Arbor 48106-1248, USA.
Am J Public Health. 2000 Dec;90(12):1898-904. doi: 10.2105/ajph.90.12.1898.
The goals of this study were to estimate prospective mortality risks of city residence, specify how these risks vary by population subgroup, and explore possible explanations.
Data were derived from a probability sample of 3617 adults in the coterminous United States and analyzed via cross-tabular and Cox proportional hazards methods.
After adjustment for baseline sociodemographic and health variables, city residents had a mortality hazard rate ratio of 1.62 (95% confidence interval [CI] = 1.21, 2.18) relative to rural/small-town residents; suburbanites had an intermediate but not significantly elevated hazard rate ratio. This urban mortality risk was significant among men (hazard rate ratio: 2.25), especially non-Black men, but not among women. Among Black men, and to some degree Black women, suburban residence carried the greatest risk. All risks were most evident for those younger than 65 years.
The mortality risk of city residence, at least among men, rivals that of major psychosocial risk factors such as race, low income, smoking, and social isolation and merits comparable attention in research and policy.
本研究的目标是估计城市居民的预期死亡风险，明确这些风险如何因人群亚组而异，并探索可能的解释。
数据来自美国本土3617名成年人的概率样本，并通过交叉表和Cox比例风险方法进行分析。
在对基线社会人口统计学和健康变量进行调整后，相对于农村/小镇居民，城市居民的死亡风险率比值为1.62（95%置信区间[CI]=1.21, 2.18）；郊区居民的风险率比值处于中间水平，但未显著升高。这种城市死亡风险在男性中显著（风险率比值：2.25），尤其是非黑人男性，但在女性中不显著。在黑人男性以及在一定程度上的黑人女性中，居住在郊区的风险最大。所有风险在65岁以下人群中最为明显。
城市居民的死亡风险，至少在男性中，与种族、低收入、吸烟和社会隔离等主要心理社会风险因素相当，在研究和政策方面值得同等关注。
