Agyemang Charles, van Hooijdonk Carolien, Wendel-Vos Wanda, Ujcic-Voortman Joanne K, Lindeman Ellen, Stronks Karien, Droomers Mariel
Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
BMC Public Health. 2007 Jun 23;7:118. doi: 10.1186/1471-2458-7-118.
Evidence strongly suggests that the neighbourhood in which people live influences their health. Despite this, investigations of ethnic differences in cardiovascular risk factors have focused mainly on individual-level characteristics. The main purpose of this study was to investigate associations between neighbourhood-level environmental stressors (crime, housing density, nuisance from alcohol and drug misuse, quality of green space and social participation), and blood pressure (BP) and hypertension among different ethnic groups.
Individual data from the Amsterdam Health Survey 2004 were linked to data on neighbourhood stressors creating a multilevel design for data analysis. The study sample consisted of 517 Dutch, 404 Turkish and 365 Moroccans living in 15 neighbourhoods in Amsterdam, the Netherlands.
Amongst Moroccans, high density housing and nuisance from drug misuse were associated with a higher systolic BP, while high quality of green space and social participation were associated with a lower systolic BP. High level of nuisance from drug misuse was associated with a higher diastolic BP. High quality of green space was associated with lower odds of hypertension. Amongst Turkish, high level of crime and nuisance from motor traffic were associated with a higher diastolic BP. Similar associations were observed among the Dutch group but none of the differences were statistically significant.
The study findings show that neighbourhood-level stressors are associated with BP in ethnic minority groups but were less evident in the Dutch group. These findings might imply that the higher BP levels found in some ethnic minority groups might be partly due to their greater susceptibility to the adverse neighbourhood environment in which many ethnic minority people live. Primary prevention measures targeting these neighbourhood stressors may have an impact in reducing high BP related morbidity and mortality among ethnic minority groups.
有力证据表明人们居住的社区会影响其健康。尽管如此，对心血管危险因素种族差异的调查主要集中在个体层面特征上。本研究的主要目的是调查社区层面的环境压力源（犯罪、住房密度、酒精和药物滥用造成的滋扰、绿地质量和社会参与度）与不同种族群体的血压（BP）及高血压之间的关联。
将2004年阿姆斯特丹健康调查的个体数据与社区压力源数据相链接，创建用于数据分析的多层次设计。研究样本包括居住在荷兰阿姆斯特丹15个社区的517名荷兰人、404名土耳其人和365名摩洛哥人。
在摩洛哥人群中，高密度住房和药物滥用造成的滋扰与收缩压升高相关，而高质量的绿地和社会参与度与收缩压降低相关。药物滥用造成的高水平滋扰与舒张压升高相关。高质量的绿地与高血压几率降低相关。在土耳其人群中，高水平的犯罪和机动车交通造成的滋扰与舒张压升高相关。在荷兰人群中也观察到了类似的关联，但没有差异具有统计学意义。
研究结果表明，社区层面的压力源与少数族裔群体的血压相关，但在荷兰人群中不太明显。这些发现可能意味着，一些少数族裔群体中较高的血压水平可能部分归因于他们对许多少数族裔居住的不利社区环境更易敏感。针对这些社区压力源的一级预防措施可能会对降低少数族裔群体中与高血压相关的发病率和死亡率产生影响。
