Center for Primary Health Care Research, Lund University, Malmö, Sweden.
J Epidemiol Community Health. 2011 Oct;65(10):866-72. doi: 10.1136/jech.2010.117580. Epub 2011 Feb 4.
It has been hypothesised that the presence of health-damaging factors and lack of health-promoting factors lie in the causal pathway between neighbourhood deprivation and coronary heart disease (CHD). This study is the first to examine the associations between individual-level CHD risk and neighbourhood availability of fast-food restaurants, bars/pubs, physical activity facilities and healthcare resources.
Multilevel logistic regression models were used for the follow-up of 1 065 000 men and 1 100 000 women (aged 35-80 years) between 1 December 2005 and 31 December 2007, for individual-level CHD events (both morbidity and mortality).
The relatively weak associations between neighbourhood availability of potentially health-damaging and health-promoting goods, services and resources, and CHD incidence no longer remained significant after adjustment for neighbourhood-level deprivation and individual-level age and income.
The presence of potentially health-damaging factors and lack of potentially health-promoting factors do not seem to contribute significantly to the development of CHD. Other features of deprived neighbourhoods appear to play a greater role.
据推测，在社区贫困与冠心病（CHD）之间的因果关系中，存在着损害健康的因素和缺乏促进健康的因素。本研究首次探讨了个体 CHD 风险与快餐店、酒吧/酒馆、体育活动设施和医疗保健资源在社区供应方面的关联。
2005 年 12 月 1 日至 2007 年 12 月 31 日，对 106.5 万名男性和 110 万名女性（年龄在 35-80 岁之间）进行了随访，采用多水平逻辑回归模型来分析个体 CHD 事件（发病率和死亡率）。
在调整了社区贫困程度和个体年龄、收入等因素后，社区中潜在的有害和有益商品、服务和资源的供应与 CHD 发生率之间的关联变得相对较弱，且不再具有统计学意义。
潜在有害因素和缺乏潜在促进健康因素的存在似乎对 CHD 的发展没有显著贡献。贫困社区的其他特征似乎起着更大的作用。
