Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA.
Am J Epidemiol. 2013 Feb 15;177(4):299-309. doi: 10.1093/aje/kws372. Epub 2013 Jan 20.
We used cross-sectional data on 2,660 black and 2,611 Mexican-American adult participants in the National Health and Nutrition Examination Survey (1999-2006) to investigate the association between metropolitan-level racial/ethnic residential segregation and obesity and to determine whether it was mediated by the neighborhood socioeconomic environment. Residential segregation was measured using the black and Hispanic isolation indices. Neighborhood poverty and negative income incongruity were assessed as mediators. Multilevel Poisson regression with robust variance estimates was used to estimate prevalence ratios. There was no relationship between segregation and obesity among men. Among black women, in age-, nativity-, and metropolitan demographic-adjusted models, high segregation was associated with a 1.29 (95% confidence interval (CI): 1.00, 1.65) times higher obesity prevalence than was low segregation; medium segregation was associated with a 1.35 (95% CI: 1.07, 1.70) times higher obesity prevalence. Mexican-American women living in high versus low segregation areas had a significantly lower obesity prevalence (prevalence ratio, 0.54; 95% CI: 0.33, 0.90), but there was no difference between those living in medium versus low segregation areas. These associations were not mediated by neighborhood poverty or negative income incongruity. These findings suggest variability in the interrelationships between residential segregation and obesity for black and Mexican-American women.
我们使用了横断面数据,对 2660 名黑人以及 2611 名墨西哥裔美国成年人参与者(1999-2006 年)进行了研究,以调查大都市层面的种族/族裔居住隔离与肥胖之间的关联,并确定这种关联是否受到邻里社会经济环境的影响。居住隔离通过黑人和西班牙裔隔离指数来衡量。邻里贫困和负收入不一致性被评估为中介因素。采用具有稳健方差估计的多层次泊松回归来估计患病率比。在男性中,隔离与肥胖之间没有关系。在黑人女性中,在年龄、出生地和大都市人口调整模型中,与低隔离相比,高隔离与肥胖患病率增加 1.29 倍(95%置信区间:1.00,1.65)相关;中隔离与肥胖患病率增加 1.35 倍(95%置信区间:1.07,1.70)相关。与生活在低隔离区的墨西哥裔美国女性相比,生活在高隔离区的女性肥胖患病率显著较低(患病率比,0.54;95%置信区间:0.33,0.90),而生活在中隔离区与低隔离区的女性之间没有差异。这些关联不受邻里贫困或负收入不一致性的影响。这些发现表明,居住隔离与肥胖之间的相互关系在黑人和墨西哥裔美国女性中存在差异。