对美国一个大型队列中社区社会经济剥夺与自评健康的前瞻性调查。
A prospective investigation of neighborhood socioeconomic deprivation and self-rated health in a large US cohort.
作者信息
Xiao Qian, Berrigan David, Matthews Charles E
机构信息
Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA.
Division of Cancer Control and Population Sciences, National Cancer Institute, USA.
出版信息
Health Place. 2017 Mar;44:70-76. doi: 10.1016/j.healthplace.2017.01.003. Epub 2017 Feb 6.
Abstract
BACKGROUND
Neighborhood characteristics play a critical role in health. Self-rated health (SRH) is an important indicator of quality of life and a strong predictor of premature death. Prospective study on neighborhood deprivation and SRH is limited.
METHODS
We examined neighborhood socioeconomic deprivation with reporting fair/poor SRH at follow-up (2004-2006) in 249,265 men and women (age 50-71) who reported SRH as good or better at baseline (1995-1996) in the NIH-AARP Health and Diet Study. Baseline addresses were geocoded and linked to 2000 Census. Census tract level variables were used to generate a socioeconomic deprivation index by principle component analysis.
RESULTS
Residents of more deprived neighborhoods had a higher risk of developing poor/fair SRH at follow-up, even after adjusting for individual-level factors (Odds ratio (95% confidence interval) : 1.26 (1.20, 1.32), p-trend: <0.0001). The results were largely consistent across subgroups with different demographics, health behaviors, and disease conditions and after excluding participants who moved away from their baseline address.
CONCLUSION
Neighborhood disadvantage predicts SRH over 10 years.
摘要
背景
社区特征对健康起着关键作用。自我评估健康状况（SRH）是生活质量的重要指标，也是过早死亡的有力预测因素。关于社区贫困与SRH的前瞻性研究有限。
方法
在国立卫生研究院-美国退休人员协会健康与饮食研究中，我们对249,265名年龄在50至71岁之间、在基线（1995 - 1996年）时报告SRH为良好或更好的男性和女性进行了研究，在随访（2004 - 2006年）时检查社区社会经济剥夺情况与报告的SRH为一般或较差之间的关系。对基线地址进行地理编码并与2000年人口普查数据相链接。利用普查区层面的变量，通过主成分分析生成社会经济剥夺指数。
结果
即使在调整了个体层面因素之后，生活在贫困程度更高社区的居民在随访时出现SRH为一般或较差的风险更高（优势比（95%置信区间）：1.26（1.20，1.32），p趋势：<0.0001）。在不同人口统计学、健康行为和疾病状况的亚组中，以及在排除搬离基线地址的参与者之后，结果基本一致。
结论
社区劣势在10年以上的时间里可预测SRH。
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