Department of Community Medicine and Public Health, Örebro County Council, Sweden.
BMC Public Health. 2010 Oct 21;10:628. doi: 10.1186/1471-2458-10-628.
In previous public health surveys large differences in health have been shown between citizens living in different neighbourhoods in the Örebro municipality, which has about 125000 inhabitants. The aim of this study was to investigate the determinants of health with an emphasis on the importance of neighbourhood characteristics such as the influence of neighbourhood social cohesion and social capital. The point of departure in this study was a conceptual model inspired by the work of Carpiano, where different factors related to the neighbourhood have been used to find associations to individual self-rated health.
We used data from the survey 'Life & Health 2004' sent to inhabitants aged 18-84 years in Örebro municipality, Sweden. The respondents (n = 2346) answered a postal questionnaire about living conditions, housing conditions, health risk factors and individual health. The outcome variable was self-rated health. In the analysis we applied logistic regression modelling in various model steps following a conceptual model.
The results show that poor self-rated health was associated with social capital, such as lack of personal support and no experience of being made proud even after controlling for strong factors related to health, such as age, disability pension, ethnicity and economic stress. Also the neighbourhood factors, housing area and residential stability were associated with self-rated health. Poor self-rated health was more common among people living in areas with predominately large blocks of flats or areas outside the city centre. Moreover, people who had lived in the same area 1-5 years reported poor health more frequently than those who had lived there longer.
The importance of the neighbourhood and social capital for individual health is confirmed in this study. The neighbourhoods could be emphasized as settings for health promotion. They can be constructed to promote social interaction which in turn supports the development of social networks, social support and social capital--all important determinants of health.
在奥雷布洛市以前的公共卫生调查中，居住在不同街区的市民健康状况存在很大差异，该市约有 125000 名居民。本研究旨在调查健康的决定因素，重点关注邻里特征的重要性，如邻里社会凝聚力和社会资本的影响。本研究的出发点是受 Carpiano 工作启发的概念模型，该模型使用了与邻里有关的不同因素来寻找与个体自评健康相关的因素。
我们使用了来自瑞典奥雷布洛市“2004 年生活与健康”调查的数据。被调查者（n=2346）回答了一份关于居住条件、住房条件、健康风险因素和个体健康的邮寄问卷。因变量为自评健康。在分析中，我们按照概念模型，在不同的模型步骤中应用了逻辑回归模型。
结果表明，即使在控制了与健康相关的强因素（如年龄、残疾抚恤金、族裔和经济压力）后，自评健康状况不佳仍与社会资本相关，如缺乏个人支持和没有感到自豪的经历。邻里因素，如住房面积和居住稳定性也与自评健康相关。自评健康状况不佳的人更常见于居住在以大型公寓楼为主或位于市中心以外地区的人。此外，与居住在同一地区 1-5 年的人相比，居住在同一地区 5 年以上的人报告健康状况不佳的频率更高。
本研究证实了邻里和社会资本对个体健康的重要性。邻里可以作为促进健康的场所加以强调。可以构建邻里环境，以促进社会互动，从而支持社会网络、社会支持和社会资本的发展，这些都是健康的重要决定因素。
