Loh Venurs H Y, Rachele Jerome N, Brown Wendy J, Washington Simon, Turrell Gavin
Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia; School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
Centre for Research on Exercise, Physical Activity and Health, University of Queensland, Brisbane, QLD, Australia; School of Human Movement and Nutrition Studies, University of Queensland, Brisbane, QLD, Australia.
Prev Med. 2016 Aug;89:112-120. doi: 10.1016/j.ypmed.2016.05.007. Epub 2016 May 16.
Understanding associations between physical function and neighborhood disadvantage may provide insights into which interventions might best contribute to reducing socioeconomic inequalities in health. This study examines associations between neighborhood-disadvantage, individual-level socioeconomic position (SEP) and physical function from a multilevel perspective.
Data were obtained from the HABITAT multilevel longitudinal (2007-13) study of middle-aged adults, using data from the fourth wave (2013). This investigation included 6004 residents (age 46-71years) of 535 neighborhoods in Brisbane, Australia. Physical function was measured using the PF-10 (0-100), with higher scores indicating better function. The data were analyzed using multilevel linear regression and were extended to test for cross-level interactions by including interaction terms for different combinations of SEP (education, occupation, household income) and neighborhood disadvantage on physical function.
Residents of the most disadvantaged neighborhoods reported significantly lower physical function (men: β -11.36 95% CI -13.74, -8.99; women: β -11.41 95% CI -13.60, -9.22). These associations remained after adjustment for individual-level SEP. Individuals with no post-school education, those permanently unable to work, and members of the lowest household income had significantly poorer physical function. Cross-level interactions suggested that the relationship between household income and physical function is different across levels of neighborhood disadvantage for men; and for education and occupation for women.
Living in a disadvantaged neighborhood was negatively associated with physical function after adjustment for individual-level SEP. These results may assist in the development of policy-relevant targeted interventions to delay the rate of physical function decline at a community-level.
了解身体功能与邻里劣势之间的关联，可能有助于洞察哪些干预措施最有助于减少健康方面的社会经济不平等。本研究从多层次视角考察邻里劣势、个体层面的社会经济地位（SEP）与身体功能之间的关联。
数据取自HABITAT对中年成年人的多层次纵向（2007 - 2013年）研究，采用第四轮（2013年）的数据。本次调查涵盖了澳大利亚布里斯班535个社区的6004名居民（年龄在46 - 71岁之间）。使用PF - 10（0 - 100）来测量身体功能，得分越高表明功能越好。数据采用多层次线性回归进行分析，并通过纳入SEP（教育、职业、家庭收入）与邻里劣势对身体功能的不同组合的交互项，扩展以检验跨层次交互作用。
最劣势社区的居民报告的身体功能显著更低（男性：β - 11.36，95%置信区间 - 13.74， - 8.99；女性：β - 11.41，95%置信区间 - 13.60， - 9.22）。在对个体层面的SEP进行调整后，这些关联依然存在。未接受过学校后教育的个体、永久无法工作的个体以及家庭收入最低的成员，其身体功能显著更差。跨层次交互作用表明，男性家庭收入与身体功能之间的关系在不同邻里劣势水平上存在差异；女性在教育和职业方面也是如此。
在对个体层面的SEP进行调整后，生活在劣势社区与身体功能呈负相关。这些结果可能有助于制定与政策相关的针对性干预措施，以在社区层面延缓身体功能下降的速度。
