Department of Health Systems and Policy, School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway, USA.
Am J Public Health. 2011 Jan;101(1):79-86. doi: 10.2105/AJPH.2009.178640. Epub 2010 Mar 18.
To strengthen existing evidence on the role of neighborhoods in chronic disease onset in later life, we investigated associations between multiple neighborhood features and 2-year onset of 6 common conditions using a national sample of older adults.
Neighborhood features for adults aged 55 years or older in the 2002 Health and Retirement Study were measured by use of previously validated scales reflecting the built, social, and economic environment. Two-level random-intercept logistic models predicting the onset of heart problems, hypertension, stroke, diabetes, cancer, and arthritis by 2004 were estimated.
In adjusted models, living in more economically disadvantaged areas predicted the onset of heart problems for women (odds ratio [OR] = 1.20; P < .05). Living in more highly segregated, higher-crime areas was associated with greater chances of developing cancer for men (OR = 1.31; P < .05) and women (OR = 1.25; P < .05).
The neighborhood economic environment is associated with heart disease onset for women, and neighborhood-level social stressors are associated with cancer onset for men and women. The social and biological mechanisms that underlie these associations require further investigation.
为了加强有关邻里环境在老年人慢性病发病中的作用的现有证据，我们利用全国老年人样本，调查了多种邻里特征与 6 种常见疾病在 2 年内发病的关联。
使用先前验证过的反映建筑、社会和经济环境的量表，测量了 2002 年健康与退休研究中年龄在 55 岁及以上成年人的邻里特征。采用两水平随机截距逻辑模型，预测到 2004 年心脏病、高血压、中风、糖尿病、癌症和关节炎的发病情况。
在调整后的模型中，生活在经济条件较差的地区会增加女性患心脏病的几率（比值比 [OR] = 1.20；P <.05）。生活在隔离程度更高、犯罪率更高的地区，会增加男性（OR = 1.31；P <.05）和女性（OR = 1.25；P <.05）患癌症的几率。
邻里的经济环境与女性心脏病发病有关，邻里层面的社会压力源与男性和女性的癌症发病有关。这些关联的潜在社会和生物学机制需要进一步研究。
