Calling Susanna, Li Xinjun, Kawakami Naomi, Hamano Tsuyoshi, Sundquist Kristina
Department of Clinical Sciences, Center for Primary Health Care Research, Skåne University Hospital, Lund University, Clinical Research Centre (CRC), Building 28, floor 11, Jan Waldenströms gata 35, 205 02, Malmö, Sweden.
Waseda Institute of Sport Sciences, Waseda University, Tokorozawa Saitama, Japan.
BMC Public Health. 2016 Jul 26;16:634. doi: 10.1186/s12889-016-3293-5.
Living in a socially deprived neighborhood is associated with lifestyle risk factors, e.g., smoking, physical inactivity and unhealthy diet, as well as an increased risk of cardiovascular disease, i.e., coronary heart disease and stroke. The aim was to study whether the odds of cardiovascular disease vary with the neighbourhood availability of potentially health-damaging and health-promoting resources.
A nationwide sample of 2 040 826 men and 2 153 426 women aged 35-80 years were followed for six years for first hospitalization of coronary heart disease or stroke. Neighborhood availability of health-damaging resources (i.e., fast-food restaurants and bars/pubs) and health-promoting resources (i.e., health care facilities and physical activity facilities) were determined by use of geographic information systems (GIS).
We found small or modestly increased odds ratios (ORs) for both coronary heart disease and stroke, related to the availability of both health-damaging and health-promoting resources. For example, in women, the unadjusted OR (95 % confidence interval) for stroke in relation to availability of fast-food restaurants was 1.18 (1.15-1.21). Similar patterns were observed in men, with an OR = 1.08 (1.05-1.10). However, the associations became weaker or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income.
This six year follow-up study shows that neighborhood availability of potentially health-damaging as well as health-promoting resources may make a small contribution to the risk of coronary heart disease and stroke. However, most of these associations were attenuated or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. Future studies are needed to further examine factors in the causal pathway between neighborhood deprivation and cardiovascular disease.
生活在社会贫困社区与生活方式风险因素相关，如吸烟、缺乏体育锻炼和不健康饮食，以及心血管疾病（即冠心病和中风）风险增加。目的是研究心血管疾病的几率是否随社区中潜在有害健康和促进健康资源的可及性而变化。
对全国范围内2040826名年龄在35 - 80岁的男性和2153426名女性进行了为期六年的随访，以观察冠心病或中风的首次住院情况。利用地理信息系统（GIS）确定社区中有害健康资源（即快餐店和酒吧/酒馆）和促进健康资源（即医疗保健设施和体育活动设施）的可及性。
我们发现，冠心病和中风的比值比（OR）略有增加或适度增加，这与有害健康和促进健康资源的可及性均有关。例如，在女性中，与快餐店可及性相关的中风未调整OR（95%置信区间）为1.18（1.15 - 1.21）。在男性中也观察到类似模式，OR = 1.08（1.05 - 1.10）。然而，在对社区层面的贫困程度以及个体层面的年龄和收入进行调整后，这些关联变弱或消失。
这项为期六年的随访研究表明，社区中潜在有害健康以及促进健康资源的可及性可能对冠心病和中风风险有小的影响。然而，在对社区层面的贫困程度以及个体层面的年龄和收入进行调整后，这些关联大多减弱或消失。未来需要进一步研究社区贫困与心血管疾病之间因果路径中的因素。
