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个体与邻里社会经济地位及种族对青少年动态血压和心率的预测作用

Individual versus neighborhood socioeconomic status and race as predictors of adolescent ambulatory blood pressure and heart rate.

作者信息

McGrath Jennifer J, Matthews Karen A, Brady Sonya S

机构信息

Concordia University Montreal, QC, Canada.

出版信息

Soc Sci Med. 2006 Sep;63(6):1442-53. doi: 10.1016/j.socscimed.2006.03.019. Epub 2006 Jun 2.

Abstract

Socioeconomic status (SES) disparities are linked to increased cardiovascular disease risk. Although typically considered an individual or family indicator, SES alternatively can be derived from neighborhood characteristics. Previous research has found both family and neighborhood SES predict laboratory blood pressure responses in youth. The question remains as to whether this SES gradient predicts blood pressure during daily living situations. We evaluated individual versus neighborhood SES and race as predictors of ambulatory blood pressure and heart rate. Participants were recruited from two schools in Pittsburgh, diverse in terms of both race and SES. Adolescents' (N=212, 14.5 years, 50% black) cardiovascular responses were measured at school and home. Individual (parent education, household income) and neighborhood SES indices (derived from 78 census tracts: percentage with high school degree or less, percentage below poverty) were assessed. A neighborhood index of race based on the proportion of blacks in the census tract was also derived as a counterpart to individuals' race. Multi-level modeling indicated neighborhood income predicted systolic blood pressure. Individual race predicted diastolic blood pressure. Individual income and education, and neighborhood race each predicted heart rate. These results have important public health implications as they suggest individual and neighborhood SES and race are linked to cardiovascular risk disparities as early as adolescence.

摘要

社会经济地位(SES)差异与心血管疾病风险增加有关。虽然SES通常被视为个人或家庭指标,但它也可以从邻里特征中得出。先前的研究发现,家庭和邻里的SES都能预测青少年的实验室血压反应。问题仍然是,这种SES梯度是否能预测日常生活中的血压。我们评估了个人与邻里的SES以及种族作为动态血压和心率预测因素的情况。参与者从匹兹堡的两所学校招募,这两所学校在种族和SES方面都具有多样性。在学校和家中测量了青少年(N = 212,14.5岁,50%为黑人)的心血管反应。评估了个人(父母教育程度、家庭收入)和邻里SES指数(从78个人口普查区得出:高中及以下学历百分比、贫困线以下百分比)。还得出了一个基于人口普查区黑人比例的邻里种族指数,作为个人种族的对应指标。多层次模型表明,邻里收入可预测收缩压。个人种族可预测舒张压。个人收入和教育程度以及邻里种族各自可预测心率。这些结果具有重要的公共卫生意义,因为它们表明个人和邻里的SES以及种族早在青少年时期就与心血管风险差异相关。

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