Ferguson Trevor S, Younger-Coleman Novie O M, Mullings Jasneth, Francis Damian, Greene Lisa-Gaye, Lyew-Ayee Parris, Wilks Rainford
Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica.
Health Research Resource Unit, Dean's Office, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica.
PeerJ. 2020 Oct 6;8:e10058. doi: 10.7717/peerj.10058. eCollection 2020.
Neighbourhood characteristics are associated with several diseases, but few studies have investigated the association between neighbourhood and health in Jamaica. We evaluated the relationship between neighbourhood socioeconomic status (SES) and blood pressure (BP) among youth, 15-24 years old, in Jamaica.
A pooled analysis was conducted using data from three studies (two national surveys and a birth cohort), conducted between 2005-2008, with individual level BP, anthropometric and demographic data, and household SES. Data on neighbourhood SES were obtained from the Mona Geo-Informatics Institute. Neighbourhood was defined using community boundaries from the Social Development Commission in Jamaica. Community characteristics (poverty, unemployment, dependency ratio, population density, house size, and proportion with tertiary education) were combined into SES scores using principal component analysis (PCA). Multivariable analyses were computed using mixed effects multilevel models.
Analyses included 2,556 participants (1,446 females; 1,110 males; mean age 17.9 years) from 306 communities. PCA yielded two neighbourhood SES variables; the first, PCA-SES1, loaded highly positive for tertiary education and larger house size (higher value = higher SES); while the second, PCA-SES2, loaded highly positive for unemployment and population density (higher value = lower SES). Among males, PCA-SES1 was inversely associated with systolic BP (β-1.48 [95%CI -2.11, -0.84] mmHg, < 0.001, for each standard deviation unit increase in PCA-SES1 score) in multivariable model accounting for age, household SES, study, BMI, fasting glucose, physical activity and diet. PCA-SES1 was not significantly associated with systolic BP among females (β -0.48 [-1.62, 0.66], = 0.410) in a similar model. Associations for PCA-SES2 was assessed using linear splines to account for non-linear effects. The were no significant associations between systolic BP and PCA-SES2 among males. Among females, higher PCA-SES2 (i.e. lower SES) was associated with higher systolic BP at spline 2 [-score -1 to 0] (β4.09 [1.49, 6.69], = 0.002), but with lower systolic BP at spline 3 [-core 0 to 1] (β-2.81 [-5.04, -0.59], = 0.013). There were no significant associations between diastolic BP and PCA-SES1, but PCA-SES2 showed non-linear associations with diastolic BP particularly among males.
Higher neighbourhood SES was inversely associated with systolic BP among male Jamaican youth; there were non-linear associations between neighbourhood SES and systolic BP among females and for diastolic BP for both males and females.
社区特征与多种疾病相关，但很少有研究调查牙买加社区与健康之间的关联。我们评估了牙买加15至24岁青年的社区社会经济地位（SES）与血压（BP）之间的关系。
使用2005年至2008年期间进行的三项研究（两项全国性调查和一个出生队列）的数据进行汇总分析，这些研究包含个体层面的血压、人体测量和人口统计数据以及家庭SES。社区SES数据来自莫纳地理信息研究所。社区是根据牙买加社会发展委员会的社区边界定义的。使用主成分分析（PCA）将社区特征（贫困、失业、抚养比、人口密度、房屋大小和受过高等教育的比例）合并为SES分数。使用混合效应多级模型进行多变量分析。
分析纳入了来自306个社区的2556名参与者（1446名女性；1110名男性；平均年龄17.9岁）。PCA产生了两个社区SES变量；第一个，PCA-SES1，在高等教育和较大房屋大小方面负荷为高度正相关（值越高 = SES越高）；而第二个，PCA-SES2，在失业和人口密度方面负荷为高度正相关（值越高 = SES越低）。在多变量模型中，考虑年龄、家庭SES、研究、BMI、空腹血糖、身体活动和饮食后，在男性中，PCA-SES1与收缩压呈负相关（PCA-SES1分数每增加一个标准差单位，β为-1.48 [95%CI -2.11, -0.84] mmHg，P < 0.001）。在类似模型中，PCA-SES1与女性收缩压无显著关联（β为-0.48 [-1.62, 0.66]，P = 0.410）。使用线性样条评估PCA-SES2的关联以考虑非线性效应。男性收缩压与PCA-SES2之间无显著关联。在女性中，较高的PCA-SES2（即较低的SES）在样条2 [-分数-1至0]时与较高的收缩压相关（β为4.09 [1.49, 6.69]，P = 0.002），但在样条3 [-核心0至1]时与较低的收缩压相关（β为-2.81 [-5.04, -0.59]，P = 0.013）。舒张压与PCA-SES1之间无显著关联，但PCA-SES2与舒张压呈非线性关联，尤其是在男性中。
较高的社区SES与牙买加男性青年的收缩压呈负相关；社区SES与女性收缩压以及男性和女性舒张压之间存在非线性关联。
