Tamura Kosuke, Langerman Steven D, Ceasar Joniqua N, Andrews Marcus R, Agrawal Malhaar, Powell-Wiley Tiffany M
Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10-CRC, 5-5330, 10 Center Drive, Bethesda, MD 20892, USA.
Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10-CRC, 5-5330, 10 Center Drive, Bethesda, MD 20892, USA; and Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892.
Curr Cardiovasc Risk Rep. 2019 Apr;13(4). doi: 10.1007/s12170-019-0601-5. Epub 2019 Mar 8.
Limited physical activity (PA) and obesity are two primary risk factors for cardiovascular disease (CVD). Within a socio-ecological framework, neighborhood social environment may play a key role in influencing PA and obesity. However, the mechanisms underlying this relationship remain ambiguous. Our goals in this review are: (1) to summarize findings from the recent studies on neighborhood social environment in relation to PA and obesity as CVD risk factors, and (2) to briefly describe several innovative approaches to assessing neighborhood social environment.
Almost all recent studies assessed neighborhood social environment around residential areas. There were consistent associations between neighborhood social environment and PA and obesity, with some exceptions (indicating null associations or paradoxical associations). However, a focus on residential social environment may limit results because these studies did not account for any exposures occurring away from individuals' homes. Additionally, the majority of studies utilized a cross-sectional design, which limits our ability to make inferences regarding the causality of the association between social environment and PA or obesity as CV risk factors.
The majority of the studies on neighborhood social environment characterized factors around residential areas and assessed participant activity via self-reported surveys. Future research should leverage tools to account for the spatial mismatch between environmental exposures and outcomes by using global positioning systems, ecological momentary assessments, virtual neighborhood audits, and simulation modeling. These approaches can overcome major limitations by tracking individuals' daily activity and real-time perceptions of neighborhood social environments linked to CVD events.
身体活动不足和肥胖是心血管疾病（CVD）的两个主要危险因素。在社会生态框架内，邻里社会环境可能在影响身体活动和肥胖方面发挥关键作用。然而，这种关系背后的机制仍不明确。我们本次综述的目标是：（1）总结近期关于邻里社会环境与作为心血管疾病危险因素的身体活动和肥胖之间关系的研究结果，以及（2）简要描述几种评估邻里社会环境的创新方法。
几乎所有近期研究都评估了住宅区周围的邻里社会环境。邻里社会环境与身体活动和肥胖之间存在一致的关联，但也有一些例外情况（表明无关联或存在矛盾关联）。然而，关注居住社会环境可能会限制研究结果，因为这些研究没有考虑个体在家以外发生的任何暴露情况。此外，大多数研究采用横断面设计，这限制了我们推断社会环境与作为心血管疾病危险因素的身体活动或肥胖之间关联的因果关系的能力。
大多数关于邻里社会环境的研究描述了住宅区周围的因素，并通过自我报告调查评估参与者的活动。未来的研究应利用全球定位系统、生态瞬时评估、虚拟邻里审计和模拟建模等工具，以解决环境暴露与结果之间的空间不匹配问题。这些方法可以通过跟踪个体的日常活动以及与心血管疾病事件相关的邻里社会环境的实时感知来克服主要局限性。
