Slone Epidemiology Center, Boston University, Boston, Massachusetts 02215, USA.
J Rural Health. 2012 Fall;28(4):327-38. doi: 10.1111/j.1748-0361.2012.00414.x. Epub 2012 May 31.
To examine rural status and social factors as predictors of self-rated health in community-dwelling adults in the United States.
This study uses multinomial logistic and cumulative logistic models to evaluate the associations of interest in the 2006 U.S. Behavioral Risk Factor Surveillance System, a cross-sectional survey of 347,709 noninstitutionalized adults.
Self-rated health was poorer among rural residents, compared to urban residents (OR = 1.77, 95% CI: 1.54, 1.90). However, underlying risk factors such as obesity, low income, and low educational attainment were found to vary by rural status and account for the observed increased risk (OR = 1.03, 95% CI: 0.94, 1.12). There was little evidence of effect modification by rural status, though the association between obesity and self-rated health was stronger among urban residents (OR = 2.50, 95% CI: 2.38, 2.64) than among rural residents (OR = 2.18, 95% CI: 2.03, 2.34).
Our findings suggest that differences in self-rated health by rural status were attributable to differential distributions of participant characteristics and not due to differential effects of those characteristics.
探讨美国农村居民的社会地位和社会因素对其自评健康状况的预测作用。
本研究使用多项逻辑回归和累积逻辑回归模型，对 2006 年美国行为风险因素监测系统的横断面调查数据进行分析，该调查共纳入 347709 名非住院成年人。
与城市居民相比，农村居民的自评健康状况较差（OR=1.77，95%CI：1.54，1.90）。然而，肥胖、低收入和低教育程度等潜在风险因素在农村和城市居民中的分布情况存在差异，这些因素可以解释观察到的农村居民自评健康风险增加（OR=1.03，95%CI：0.94，1.12）。农村地位对效应的修饰作用很小，尽管肥胖与自评健康之间的关联在城市居民中更强（OR=2.50，95%CI：2.38，2.64），而在农村居民中则较弱（OR=2.18，95%CI：2.03，2.34）。
本研究结果表明，农村居民自评健康状况的差异归因于参与者特征的不同分布，而不是这些特征的不同影响。
