White James, Greene Giles, Farewell Daniel, Dunstan Frank, Rodgers Sarah, Lyons Ronan A, Humphreys Ioan, John Ann, Webster Chris, Phillips Ceri J, Fone David
Am J Epidemiol. 2017 Aug 15;186(4):473-480. doi: 10.1093/aje/kwx086.
Neighborhood-level interventions provide an opportunity to better understand the impact of neighborhoods on health. In 2001, the Welsh Government, United Kingdom, funded Communities First, a program of neighborhood regeneration delivered to the 100 most deprived of the 881 electoral wards in Wales. In this study, we examined the association between neighborhood regeneration and mental health. Information on regeneration activities in 35 intervention areas (n = 4,197 subjects) and 75 control areas (n = 6,695 subjects) was linked to data on mental health from a cohort study with assessments made in 2001 (before regeneration) and 2008 (after regeneration). Propensity score matching was used to estimate the change in mental health in intervention neighborhoods versus control neighborhoods. Baseline differences between intervention and control areas were of similar magnitude as produced by paired randomization of neighborhoods. Regeneration was associated with an improvement in the mental health of residents in intervention areas compared with control neighborhoods (β = 1.54, 95% confidence interval: 0.50, 2.59), suggesting a reduction in socioeconomic inequalities in mental health. There was a dose-response relationship between length of residence in regeneration neighborhoods and improvements in mental health (P-trend = 0.05). These results show that targeted regeneration of deprived neighborhoods can improve mental health.
社区层面的干预措施为更好地理解社区对健康的影响提供了契机。2001年，英国威尔士政府资助了“优先社区”项目，该项目是一项社区复兴计划，覆盖了威尔士881个选区中最贫困的100个选区。在本研究中，我们考察了社区复兴与心理健康之间的关联。将35个干预区域（n = 4197名受试者）和75个对照区域（n = 6695名受试者）的复兴活动信息与一项队列研究中的心理健康数据相联系，该队列研究在2001年（复兴前）和2008年（复兴后）进行了评估。倾向得分匹配法用于估计干预社区与对照社区心理健康状况的变化。干预区域与对照区域之间的基线差异幅度与社区配对随机分组所产生的差异相似。与对照社区相比，复兴与干预区域居民心理健康状况的改善相关（β = 1.54，95%置信区间：0.50，2.59），这表明心理健康方面的社会经济不平等有所减少。在复兴社区的居住时长与心理健康改善之间存在剂量反应关系（P趋势 = 0.05）。这些结果表明，对贫困社区进行有针对性的复兴可改善心理健康。
