Jones-Webb Rhonda, Yu Xinhua, O'Brien Jennifer, Hannan Peter, Wall Melanie, Oswald John
University of Minnesota, School of Public Health, Division of Epidemiology, Minneapolis, MN 55454, USA.
Ethn Dis. 2004 Autumn;14(4):489-96.
Cardiovascular disease (CVD) rates differ markedly by minority status, with younger Blacks having some of the highest CVD mortality rates in the United States. A major objective of this study was to assess whether socioeconomic position moderates the effects of race or minority status on CVD mortality.
The sample included 443 Black and 21,182 White men, and 415 Black and 24,929 White women, 45 years and older, who died of CVD from 1992-1998, and who had lived in the Twin Cities 5-county area. Using individual and neighborhood level measures of socioeconomic position, we hypothesized that socioeconomic position would moderate the effects of race on CVD mortality. Test hypotheses were analyzed using Poisson regression analysis.
Socioeconomic position moderated the effects of race on CVD mortality among older men, but not in older women. Older Black men who lived in more impoverished neighborhoods had significantly and disproportionately higher CVD mortality rates than did older White men living in more impoverished neighborhoods; this was not the case among older Black and White men living in less impoverished neighborhoods. Race was independently related to CVD mortality among younger men and women, with younger Black men and women having significantly higher CVD mortality rates than younger White men and women. The Black-White rate for Black women was twice that of White women.
Socioeconomic position as measured by neighborhood poverty can moderate the effects of race on CVD mortality in older Black and White men. This may not have been as apparent had socioeconomic position not been treated as a major variable of interest, and measured at multiple levels.
心血管疾病（CVD）发病率因少数族裔身份而存在显著差异，美国年轻黑人的CVD死亡率处于最高水平。本研究的一个主要目的是评估社会经济地位是否会缓和种族或少数族裔身份对CVD死亡率的影响。
样本包括443名黑人男性和21182名白人男性，以及415名黑人女性和24929名白人女性，年龄均在45岁及以上，这些人于1992年至1998年期间死于CVD，且居住在双子城5县地区。我们使用个体和社区层面的社会经济地位指标，假设社会经济地位会缓和种族对CVD死亡率的影响。使用泊松回归分析对检验假设进行分析。
社会经济地位缓和了种族对老年男性CVD死亡率的影响，但对老年女性没有这种影响。生活在贫困社区的老年黑人男性的CVD死亡率显著高于生活在贫困社区的老年白人男性，且比例失调；而生活在较不贫困社区的老年黑人和白人男性中并非如此。种族与年轻男性和女性的CVD死亡率独立相关，年轻黑人男性和女性的CVD死亡率显著高于年轻白人男性和女性。黑人女性与白人女性的死亡率之比是2倍。
以社区贫困衡量的社会经济地位可以缓和种族对老年黑人和白人男性CVD死亡率的影响。如果社会经济地位没有被视为一个主要的研究变量，且未在多个层面进行测量，这种情况可能就不那么明显了。
