Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI 02903, USA.
Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI 02903, USA.
Soc Sci Med. 2019 Nov;241:112574. doi: 10.1016/j.socscimed.2019.112574. Epub 2019 Sep 25.
Neighborhood characteristics are increasingly recognized as important determinants of cardiovascular disease (CVD) risk. However, longitudinal studies on the health impacts of neighborhood characteristics are rare. We sought to investigate whether neighborhood socioeconomic status (NSES) during birth, childhood and adulthood is associated with CVD risk factors in adulthood.
Using longitudinal data from the New England Family Study (n = 671) with 46-years of follow-up, participants' home addresses were geocoded at birth (mean age = 1.6 months), childhood (mean age = 7.1 years), and adulthood (mean age = 44.2 years) across Massachusetts and Rhode Island in the US from 1961 to 2007. We used multilevel models to evaluate associations of NSES across the life-course with systolic blood pressure, diastolic blood pressure and body mass index (BMI) in adulthood, adjusting for age, sex, race/ethnicity, mother's race, individual SES, and parental SES.
In fully adjusted models, one standard deviation higher NSES at birth was associated with a 1.9 mmHg lower SBP (95% CI: 3.8, -0.1) and 1.3 mmHg lower DBP (95%CI: 2.6,-0.03) in adulthood; while one standard deviation of higher NSES at adulthood was associated with 0.87 kg/m2 lower BMI (95%CI: 1.7, -0.1).
We found that living in a socioeconomically disadvantaged neighborhood early in life and in adulthood was associated with blood pressure and BMI, respectively, two established risk factors for CVD. Our findings support a longitudinal association between exposure to socioeconomically disadvantaged neighborhoods in early life and CVD risk factors in adulthood.
邻里特征越来越被认为是心血管疾病 (CVD) 风险的重要决定因素。然而,关于邻里特征对健康影响的纵向研究却很少。我们试图调查出生时、儿童期和成年期的邻里社会经济地位 (NSES) 是否与成年期的 CVD 危险因素有关。
利用来自美国马萨诸塞州和罗得岛州的新英格兰家庭研究(New England Family Study)的纵向数据(n=671),随访时间为 46 年。1961 年至 2007 年,参与者的家庭住址在出生时(平均年龄为 1.6 个月)、儿童期(平均年龄为 7.1 岁)和成年期(平均年龄为 44.2 岁)时进行了地理编码。我们使用多水平模型评估了一生中 NSES 与收缩压、舒张压和成年时体重指数 (BMI) 的关联,调整了年龄、性别、种族/民族、母亲的种族、个体 SES 和父母 SES。
在完全调整的模型中,出生时 NSES 每增加一个标准差,收缩压就会降低 1.9mmHg(95%CI:3.8,-0.1),舒张压降低 1.3mmHg(95%CI:2.6,-0.03);而成年时 NSES 每增加一个标准差,BMI 就会降低 0.87kg/m2(95%CI:1.7,-0.1)。
我们发现,早期生活和成年期生活在社会经济地位较低的社区与血压和 BMI 有关,这两个都是 CVD 的既定危险因素。我们的研究结果支持了生命早期接触社会经济地位较低的社区与成年期 CVD 危险因素之间的纵向关联。