Department of Medicine, University of California, San Francisco, CA 94143-0920, USA.
Am J Public Health. 2013 Feb;103(2):e31-8. doi: 10.2105/AJPH.2012.300938. Epub 2012 Dec 13.
We estimated the extent to which socioeconomic status (SES) gradients in adult asthma and rhinitis outcomes can be explained by home and neighborhood environmental factors.
Using survey data for 515 adults with either asthma or rhinitis, or both, we examined environmental mediators of SES associations with disease severity, using the Severity of Asthma Scale, and health-related quality of life (HRQL), using the Rhinasthma Scale. We defined SES on the basis of education and household income. Potential environmental mediators included home type and ownership, exposures to allergens and irritants, and a summary measure of perceived neighborhood problems. We modeled each outcome as a function of SES, and controlled for age, gender, and potential mediators.
Gradients in SES were apparent in disease severity and HRQL. Living in a rented house partially mediated the SES gradient for both severity and HRQL (P < .01). Higher perceived levels of neighborhood problems were associated with poorer HRQL and partially mediated the income-HRQL relationship (P < .01).
Differences in home and neighborhood environments partially explained associations of SES with adult asthma and rhinitis outcomes.
我们评估了家庭和邻里环境因素在多大程度上可以解释社会经济地位（SES）与成人哮喘和鼻炎结局之间的梯度关系。
使用 515 名哮喘或鼻炎或两者并存的成年人的调查数据，我们使用哮喘严重程度量表评估 SES 与疾病严重程度之间的关联的环境中介物，使用 Rhinasthma 量表评估与健康相关的生活质量（HRQL）。我们根据教育程度和家庭收入来定义 SES。潜在的环境中介物包括家庭类型和所有权、过敏原和刺激物暴露以及感知邻里问题的综合指标。我们将每个结果建模为 SES 的函数，并控制年龄、性别和潜在的中介物。
SES 梯度在疾病严重程度和 HRQL 方面表现明显。居住在出租房屋中部分解释了严重程度和 HRQL 的 SES 梯度（P <.01）。感知到更多的邻里问题与较差的 HRQL 相关，并部分解释了收入与 HRQL 之间的关系（P <.01）。
家庭和邻里环境的差异部分解释了 SES 与成人哮喘和鼻炎结局之间的关联。
