Augustin Toms, Glass Thomas A, James Bryan D, Schwartz Brian S
Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
Am J Public Health. 2008 Sep;98(9):1664-70. doi: 10.2105/AJPH.2007.125138. Epub 2008 Jul 16.
We examined associations between cardiovascular disease and neighborhood psychosocial hazards, such as violent crime, abandoned buildings, and signs of incivility, to evaluate whether features of place are associated with older adult health.
We analyzed first-visit data from the Baltimore Memory Study of randomly selected residents aged 50 to 70 years (n=1140) of 65 contiguous neighborhoods in Baltimore, Maryland. We looked for associations between self-reports of history of selected cardiovascular diseases and scores on the 12-item neighborhood psychosocial hazards scale.
After adjustment for established individual risk factors for cardiovascular disease, residents in neighborhoods with scores in the highest quartile of the psychosocial hazards scale had more than 4 times higher odds of a history of myocardial infarction and more than 3 times higher odds of myocardial infarction, stroke, transient ischemic attack, or intermittent claudication compared with residents living in neighborhoods scoring in the lowest quartile.
Neighborhood psychosocial hazards were significantly associated with self-reported cardiovascular disease after adjustment for individual-level risk factors. This is consistent with the hypothesis that environmental stress plays a role in the etiology of cardiovascular disease.
我们研究了心血管疾病与社区心理社会危险因素之间的关联，如暴力犯罪、废弃建筑和不文明迹象，以评估场所特征是否与老年人健康相关。
我们分析了马里兰州巴尔的摩市65个相邻社区中随机选取的50至70岁居民（n = 1140）的巴尔的摩记忆研究首次访视数据。我们寻找特定心血管疾病病史的自我报告与12项社区心理社会危险因素量表得分之间的关联。
在对已确定的心血管疾病个体危险因素进行调整后，心理社会危险因素量表得分处于最高四分位数的社区居民发生心肌梗死病史的几率比得分处于最低四分位数的社区居民高4倍多，发生心肌梗死、中风、短暂性脑缺血发作或间歇性跛行的几率比后者高3倍多。
在对个体水平的危险因素进行调整后，社区心理社会危险因素与自我报告的心血管疾病显著相关。这与环境压力在心血管疾病病因中起作用的假设一致。
