Subramanian S V, Kubzansky Laura, Berkman Lisa, Fay Martha, Kawachi Ichiro
Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA.
J Gerontol B Psychol Sci Soc Sci. 2006 May;61(3):S153-60. doi: 10.1093/geronb/61.3.s153.
The purpose of this study was to investigate the independent relationship between neighborhood context (characterized through age structure, economic conditions, service provision, and residential stability) and self-reported health among elders in one U.S. city.
By using multilevel statistical models, we examined the cross-sectional relationships between markers of neighborhood environment (derived from the 1980 U.S. Census and the Yellow Pages of the 1985 New Haven, Connecticut, telephone book) and self-rated health among elders. We used survey data from the 1985 New Haven Established Populations for Epidemiologic Studies of the Elderly, which comprised 1,926 elders nested within 28 census tracts.
When controlled for individual age, gender, race, marital status, education, and income, neighborhood measures of percent poverty were positively associated with poor self-rated health (odds ratio [OR] = 1.09; 95% confidence interval [CI] = 1.02-1.17), whereas residential stability (OR = 0.90; 95% CI = 0.84-0.96) and concentration of elders (OR = 0.82; 95% CI = 0.72-0.94) were inversely associated with poor self-rated health. Neighborhood service density was not associated with self-rated health.
We found support for the role of neighborhood structural context (reflected through measures of poverty, residential stability, and age-based demographic concentration) in predicting the health of elders. Density of neighborhood services did not appear to have an independent effect on the self-rated health of elders.
本研究旨在调查美国一个城市中邻里环境（通过年龄结构、经济状况、服务提供和居住稳定性来表征）与老年人自我报告健康状况之间的独立关系。
我们使用多层次统计模型，研究邻里环境指标（源自1980年美国人口普查以及1985年康涅狄格州纽黑文市电话簿黄页）与老年人自评健康之间的横断面关系。我们使用了1985年纽黑文市老年流行病学研究既定人群的调查数据，该数据包含嵌套在28个人口普查区中的1926名老年人。
在控制了个体年龄、性别、种族、婚姻状况、教育程度和收入后，邻里贫困百分比指标与自评健康状况不佳呈正相关（比值比[OR]=1.09；95%置信区间[CI]=1.02 - 1.17），而居住稳定性（OR = 0.90；95% CI = 0.84 - 0.96）和老年人集中度（OR = 0.82；95% CI = 0.72 - 0.94）与自评健康状况不佳呈负相关。邻里服务密度与自评健康无关。
我们发现邻里结构环境（通过贫困、居住稳定性和基于年龄的人口集中度指标反映）在预测老年人健康方面发挥作用的证据。邻里服务密度似乎对老年人的自评健康没有独立影响。
