Collins Timothy W, Kim Young-an, Grineski Sara E, Clark-Reyna Stephanie
Department of Sociology and Anthropology, University of Texas of El Paso, 500 West University Ave, El Paso, TX 79968, USA.
Department of Criminology, Law and Society, University of California Irvine, 2340 Social Ecology II, Irvine, CA 92697, USA.
Int J Environ Res Public Health. 2014 Aug 6;11(8):7856-73. doi: 10.3390/ijerph110807856.
Prior research suggests that economic deprivation has a generally negative influence on residents' health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA) at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children's current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor's asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children's wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor) Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health.
先前的研究表明，经济贫困通常会对居民健康产生负面影响。我们采用分层逻辑回归模型，以检验经济贫困在邻里和个体层面上是否会给居住在美国得克萨斯州埃尔帕索市的西班牙裔儿童带来呼吸健康风险或益处，以及经济贫困的个体层面健康影响是否会因邻里层面的经济贫困而有所不同。数据来自美国人口普查局以及一项针对埃尔帕索学童的基于人群的调查。因变量是儿童当前的喘息情况，这是一种既定的呼吸疾病发病率衡量指标，适用于那些不太可能接受医生哮喘诊断的经济贫困儿童。结果显示，邻里和个体层面的经济贫困（基于贫困状况衡量）与西班牙裔儿童喘息几率降低相关。敏感性分析揭示了个体和邻里层面贫困对医生诊断哮喘几率的类似显著影响。邻里层面的贫困并未显著改变所观察到的个体层面贫困与西班牙裔儿童喘息之间的关联；然而，邻里贫困程度越高，往往对贫困（而非非贫困）西班牙裔儿童的保护作用越强。这些发现支持了一种全新的、多层次的理解，即经济贫困对西班牙裔健康产生看似矛盾的影响。
