Walker J, Mitchell R, Petticrew M, Platt S
Research Unit in Health, Behaviour and Change (RUHBC), School of Clinical Sciences & Community Health, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK.
J Epidemiol Community Health. 2009 Jan;63(1):12-7. doi: 10.1136/jech.2008.074096. Epub 2008 Sep 18.
To assess the effect of a publicly funded domestic heating programme on self-reported health.
DESIGN, SETTING AND PARTICIPANTS: A prospective controlled study of 1281 households in Scotland receiving new central heating under a publicly funded initiative, and 1084 comparison households not receiving new heating. The main outcome measures were self-reported diagnosis of asthma, bronchitis, eczema, nasal allergy, heart disease, circulatory problems or high blood pressure; number of primary care encounters and hospital contacts in the past year; and SF-36 Health Survey scores.
Usable data were obtained from 61.4% of 3849 respondents originally recruited. Heating recipients reported higher scores on the SF-36 Physical Functioning scale (difference 2.51; 95% CI 0.67 to 4.37) and General Health scale (difference 2.57; 95% CI 0.90 to 4.34). They were less likely to report having received a first diagnosis of heart disease (OR 0.69; 95% CI 0.52 to 0.91) or high blood pressure (OR 0.77; 95% CI 0.61 to 0.97), but the groups did not differ significantly in use of primary care or hospital services.
Provision of central heating was associated with significant positive effects on general health and physical functioning; however, effect sizes were small. Evidence of a reduced risk of first diagnosis with heart disease or high blood pressure must be interpreted with caution, due to the self-reported nature of the outcomes, the limited time period and the failure to detect any difference in health service use.
评估一项由公共资金资助的家庭供暖计划对自我报告健康状况的影响。
设计、背景与参与者：一项前瞻性对照研究，研究对象为苏格兰1281户通过公共资金资助项目获得新的中央供暖系统的家庭，以及1084户未获得新供暖系统的对照家庭。主要结局指标包括自我报告的哮喘、支气管炎、湿疹、鼻过敏、心脏病、循环系统问题或高血压诊断情况；过去一年中初级保健就诊次数和医院就诊次数；以及SF-36健康调查评分。
从最初招募的3849名受访者中，61.4%的人获得了可用数据。接受供暖的人群在SF-36身体功能量表（差异为2.51；95%置信区间为0.67至4.37）和总体健康量表（差异为2.57；95%置信区间为0.90至4.34）上得分更高。他们报告首次诊断出心脏病（比值比0.69；95%置信区间为0.52至0.91）或高血压（比值比0.77；95%置信区间为0.61至0.97）的可能性较小，但两组在初级保健或医院服务的使用上没有显著差异。
提供中央供暖与对总体健康和身体功能有显著的积极影响相关；然而，效应量较小。由于结局是自我报告性质、时间段有限且未发现卫生服务使用方面的任何差异，因此对于首次诊断心脏病或高血压风险降低的证据必须谨慎解读。
