Patel Kushang V, Eschbach Karl, Rudkin Laura L, Peek M Kristen, Markides Kyriakos S
Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA.
Ann Epidemiol. 2003 Oct;13(9):620-8. doi: 10.1016/S1047-2797(03)00060-7.
To determine whether neighborhood characteristics are associated with self-rated health in older Mexican Americans.
Epidemiologic data on 3050 older Mexican Americans residing in the southwestern United States during 1993 and 1994 were merged with 1990 US Census data. All subjects were matched to one of 210 census tracts (neighborhoods). Multilevel ordinal logit models were used to examine relationships between self-rated health and individual- and neighborhood-level variables.
After adjusting for individual characteristics, older Mexican Americans were more likely to rate their health poorer if they lived in neighborhoods that were economically disadvantaged, less populated by other Hispanics, or located within 50 miles of the US-Mexico border. In addition, residence in a border community moderated the relationship between self-rated health and neighborhood economic disadvantage. The effect of neighborhood economic disadvantage on poorer self-rated health was two to three times stronger for subjects living near the border region than subjects living further away from the border.
This study demonstrates the importance of considering several dimensions of neighborhood context, especially for Mexican Americans. Residence in a border community and neighborhood economic disadvantage were important predictors of poorer self-rated health status. In addition, older Mexican Americans experience a health benefit from living in neighborhoods populated with other Hispanics.
确定邻里特征是否与老年墨西哥裔美国人的自评健康状况相关。
将1993年和1994年居住在美国西南部的3050名老年墨西哥裔美国人的流行病学数据与1990年美国人口普查数据合并。所有受试者都与210个人口普查区(邻里)之一进行了匹配。使用多级有序logit模型来检验自评健康与个体及邻里层面变量之间的关系。
在调整个体特征后,如果老年墨西哥裔美国人居住在经济上处于劣势、其他西班牙裔人口较少或位于美墨边境50英里范围内的邻里中,他们更有可能给自己的健康状况评分为较差。此外,居住在边境社区调节了自评健康与邻里经济劣势之间的关系。邻里经济劣势对自评健康较差的影响,对于居住在边境地区附近的受试者来说,是居住在离边境较远地区的受试者的两到三倍。
本研究证明了考虑邻里环境的多个维度的重要性,特别是对于墨西哥裔美国人。居住在边境社区和邻里经济劣势是自评健康状况较差的重要预测因素。此外,老年墨西哥裔美国人从居住在有其他西班牙裔人口的邻里中获得健康益处。