Jaffe Dena H, Eisenbach Zvi, Neumark Yehuda D, Manor Orly
Braun School of Public Health and Community Medicine, Hebrew University--Hadassah, Jerusalem, Israel.
Ann Epidemiol. 2005 Nov;15(10):804-10. doi: 10.1016/j.annepidem.2004.09.014.
To examine the effects of living in religiously affiliated and unaffiliated neighborhoods on mortality risks above that of individual risk factors, to determine if this effect behaves in a dose-response manner, and to examine the interaction between community wealth and religious affiliation.
Multilevel modeling of data from the Israel Longitudinal Mortality Study was used to assess mortality differentials based on neighborhood religious affiliation. Data were analyzed for 141,683 individuals aged 45 to 89 years and living in 882 statistical areas. Overall, 29,709 deaths were reported during the 9.5-year follow-up period.
After accounting for individual demographic and socioeconomic (SES) characteristics as well as area-SES, men and women living in religiously affiliated neighborhoods had lower mortality rates than those living in unaffiliated areas (odds ratio(men) = 0.75; 95% CI, 0.67-0.84; odds ratio(women) = 0.86; 95% CI, 0.67-0.96). For men, this relationship behaved in a dose-response manner. Furthermore, the beneficial effects on mortality of living in a religiously affiliated area were consistent across age groups, middle-aged and elderly. Lastly, effect modification of area-SES on area-religion was observed for women only, whereby for women living in higher-SES areas, religiosity had no effect on mortality.
The characteristics of one's immediate neighborhood, namely, community wealth and religious affiliation, have valuable health implications that should be included when assessing mortality risks.
研究居住在有宗教信仰和无宗教信仰社区对死亡率风险的影响(高于个体风险因素的影响),确定这种影响是否呈剂量反应关系,并研究社区财富与宗教信仰之间的相互作用。
使用以色列纵向死亡率研究的数据进行多层次建模,以评估基于社区宗教信仰的死亡率差异。对141,683名年龄在45至89岁之间且居住在882个统计区域的个体数据进行分析。在9.5年的随访期内,共报告了29,709例死亡。
在考虑了个体人口统计学和社会经济(SES)特征以及区域SES后,居住在有宗教信仰社区的男性和女性的死亡率低于居住在无宗教信仰社区的男性和女性(优势比(男性)= 0.75;95%置信区间,0.67 - 0.84;优势比(女性)= 0.86;95%置信区间,0.67 - 0.96)。对于男性,这种关系呈剂量反应关系。此外,居住在有宗教信仰社区对死亡率的有益影响在中年和老年等各年龄组中是一致的。最后,仅在女性中观察到区域SES对区域宗教信仰的效应修正,即对于居住在高SES区域的女性,宗教信仰对死亡率没有影响。
个人直接居住社区的特征,即社区财富和宗教信仰,对健康有重要影响,在评估死亡风险时应予以考虑。