University of Alberta, 2-281 Enterprise Square, Edmonton, AB, Canada, T5J 4P6.
University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1150.
Ann Epidemiol. 2018 Jun;28(6):356-361. doi: 10.1016/j.annepidem.2018.03.014. Epub 2018 Mar 29.
Neighborhood quality is associated with health. Increasingly, researchers are focusing on the mechanisms underlying that association, including the role of stress, risky health behaviors, and subclinical measures such as allostatic load (AL).
This study uses mixed-effects regression modeling to examine the association between two objective measures and one subjective measure of neighborhood quality and AL in an ethnically diverse population-based sample (N = 2706) from a medium-sized Texas city. We also examine whether several measures of psychological stress and health behaviors mediate any relationship between neighborhood quality and AL.
In this sample, all three separate measures of neighborhood quality were associated with individual AL (P < .01). However, only the subjective measure, perceived neighborhood quality, was associated with AL after adjusting for covariates. In mixed-effects multiple regression models there was no evidence of mediation by either stress or health behaviors.
In this study, only one measure of neighborhood quality was related to a measure of health, which contrasts with considerable previous research in this area. In this sample, neighborhood quality may affect AL through other mechanisms, or there may be other health-affecting factors is this area that share that overshadow local neighborhood variation.
邻里质量与健康有关。越来越多的研究人员开始关注这种关联的背后机制，包括压力、危险健康行为和亚临床指标（如应激反应的生理指标）的作用。
本研究使用混合效应回归模型，检验了来自得克萨斯州一个中等城市的、基于人群的、种族多样化样本（N=2706）中，两种客观邻里质量指标和一种主观邻里质量指标与应激反应的生理指标之间的关联。我们还检验了几种心理压力和健康行为指标是否在邻里质量与应激反应的生理指标之间的关系中起到了中介作用。
在该样本中，邻里质量的三种独立指标均与个体的应激反应的生理指标呈正相关（P<.01）。然而，在调整了协变量后，只有主观的邻里质量感知与应激反应的生理指标相关。在混合效应多元回归模型中，没有证据表明压力或健康行为起了中介作用。
在本研究中，只有一种邻里质量指标与健康指标有关，这与该领域之前的大量研究形成了对比。在本样本中，邻里质量可能通过其他机制影响应激反应的生理指标，或者该地区可能存在其他影响健康的因素，掩盖了当地邻里差异的影响。
