Research and Policy, Public Health Foundation of India, Gurgaon, Haryana, India.
School of Public Health, Imperial College London, London, UK.
Health Place. 2017 Sep;47:100-107. doi: 10.1016/j.healthplace.2017.08.001. Epub 2017 Aug 8.
We establish a rationale for a multilevel approach in examining health among older adults. Using data on a nationally representative sample of 6560 Indian adults aged 50 years and older, we examine the extent of contextual variation between neighborhoods, after accounting for the compositional effect of individuals' background characteristics, across multiple dimensions of elderly health. The variance apportioned to neighborhoods in null intercept-only models varied widely across different health outcomes examined in the elderly - while neighborhoods accounted for only 4% of the total variation in high blood pressure at exam, 23% of the total variation in self-rated poor quality of life could be attributed to neighborhood-level differences. In models that accounted for state, place of residence, and demographic and socioeconomic characteristics of individuals, the contribution of neighborhood to the total variation for most health outcomes was attenuated (2-11%) but persisted to exist. Our findings underscore the importance of neighborhoods in studying the health and well-being of the elderly in India.
我们为老年人健康的多层次研究方法建立了理论基础。使用来自全国代表性的 6560 名 50 岁及以上印度成年人的数据，我们在多个老年人健康维度上，在考虑个体背景特征组成效应的基础上，检验了邻里之间的背景差异程度。在零截距仅个体模型中，邻里差异在不同健康结果中的分配方差差异很大——尽管邻里差异仅占检查时高血压总变异的 4%，但自评生活质量差的总变异的 23%可以归因于邻里层面的差异。在考虑州、居住地点以及个体的人口统计学和社会经济特征的模型中，邻里对大多数健康结果的总变异的贡献有所减弱（2-11%），但仍然存在。我们的研究结果强调了邻里因素在研究印度老年人健康和福祉方面的重要性。
