Warr Deborah, Feldman Peter, Tacticos Theonie, Kelaher Margaret
Vic Health Centre for the Promotion of Mental Health and Community Wellbeing, The University of Melbourne, Victoria, Australia.
Aust N Z J Public Health. 2009 Feb;33(1):25-33. doi: 10.1111/j.1753-6405.2009.00334.x.
This paper explores associations between residents' perceptions of social incivilities and physical disorders in local environments and self-reported health status.
Surveys were conducted with 4,029 residents from 13 Neighbourhood Renewal sites and 1,857 residents of corresponding Local Government Areas in Victoria. An open-ended question asked respondents to nominate the worst things about living in their neighbourhood and this qualitative data was analysed for the range of perceptions of incivilities. Quantitative data analysis considered associations between incivilities in neighbourhood environments and self-reported health status.
Issues conceptualised as social incivilities (drug and alcohol use, dangerous driving, the behaviour of other people, feeling unsafe, noise, racism) accounted for 58% of issues nominated. Quantitative analyses suggested that increased exposure to issues related to aspects of neighbourhood safety were associated with living in a disadvantaged neighbourhood. Perceptions of lower levels of neighbourhood safety were, in turn, associated with poorer health.
Cumulative and compounding aspects of local environments that heighten feelings of insecurity and anxiety may be mechanisms through which places affect health.
While the characteristics of populations are important determinants of health outcomes, the findings endorse the value of incorporating complementary place-based approaches for addressing mechanisms that contribute to health inequalities in local environments.
本文探讨居民对当地环境中社会不文明行为和身体不适的认知与自我报告的健康状况之间的关联。
对来自13个社区更新地点的4029名居民以及维多利亚州相应地方政府区域的1857名居民进行了调查。一个开放式问题要求受访者指出在其社区生活最糟糕的事情,对这些定性数据进行分析以了解对不文明行为的认知范围。定量数据分析考虑了社区环境中的不文明行为与自我报告的健康状况之间的关联。
被概念化为社会不文明行为的问题(吸毒和酗酒、危险驾驶、他人行为、感到不安全、噪音、种族主义)占所提及问题的58%。定量分析表明,更多地接触与社区安全方面相关的问题与生活在弱势社区有关。反过来,对社区安全水平较低的认知与较差的健康状况有关。
当地环境中加剧不安全感和焦虑感的累积和复合因素可能是场所影响健康的机制。
虽然人群特征是健康结果的重要决定因素,但研究结果支持采用基于场所的补充方法来解决导致当地环境中健康不平等的机制的价值。