Duke Global Health Institute, Duke University, Durham, NC.
Trinity College of Arts & Sciences, Duke University, Durham, NC.
Ann Epidemiol. 2021 May;57:30-39. doi: 10.1016/j.annepidem.2021.02.004. Epub 2021 Feb 14.
Striking disparities persist in cardiovascular disease risk factors among minority youth. We examined the association between multiple indicators of neighborhood quality and minority youth fitness.
The primary exposure was the Child Opportunity Index (COI), a measure comprised of indicators that facilitate healthy child development. Outcome data were drawn from the 2018-2019 Fit2Play Study (Miami-Dade County, FL). Hotspot analysis evaluated COI spatial clustering. Generalized linear mixed models examined cross-sectional COI-fitness associations.
The sample included 725 youth (53% Black, 43% Hispanic; 5-17 years). Significant neighborhood quality spatial clusters were identified (Gi* = -4.85 to 5.36). Adjusting for sociodemographics, walkability was associated with lower percentiles in body mass index (BMI) and diastolic blood pressure percentiles (DBP) (β = -5.25, 95% CI: -8.88, -1.62 and β = -3.95, 95% CI: -7.02, -0.89, respectively) for all, lower skinfold thickness (β = -4.83, 95% CI: -9.97, 0.31 and higher sit-ups (β = 1.67, 95% CI: -0.17, 3.50) among girls, and lower systolic blood pressure percentiles (SBP) (β = -4.75, 95% CI: -8.99, -0.52) among boys. Greenspace was associated with higher BMI (β = 6.17, 95% CI: 2.47, 9.87), SBP (β = 3.47, 95% CI: -0.05, 6.99), and DBP (β = 4.11, 95% CI: 1.08, 7.13).
COI indicators were positively associated with youth fitness. Disparities in youth cardiovascular disease risk may be modifiable through community interventions and built environment initiatives targeting select neighborhood factors.
少数族裔青年的心血管疾病风险因素仍存在显著差异。我们研究了多个邻里质量指标与少数族裔青年健康之间的关系。
主要暴露因素是儿童机会指数（COI），这是一个由促进儿童健康发展的指标组成的衡量标准。结果数据来自 2018-2019 年的 Fit2Play 研究（佛罗里达州迈阿密戴德县）。热点分析评估了 COI 的空间聚类。广义线性混合模型检验了横断面 COI-健康相关性。
样本包括 725 名青少年（53%为黑人，43%为西班牙裔；5-17 岁）。确定了显著的邻里质量空间聚类（Gi*=-4.85 至 5.36）。调整社会人口统计学因素后，步行可达性与较低的体质指数（BMI）和舒张压百分位数（DBP）相关（β=-5.25，95%CI：-8.88，-1.62 和β=-3.95，95%CI：-7.02，-0.89，分别），对所有人来说，较低的皮褶厚度（β=-4.83，95%CI：-9.97，0.31 和更高的仰卧起坐（β=1.67，95%CI：-0.17，3.50）在女孩中，男孩的收缩压百分位数（SBP）较低（β=-4.75，95%CI：-8.99，-0.52）。绿地与较高的 BMI（β=6.17，95%CI：2.47，9.87）、SBP（β=3.47，95%CI：-0.05，6.99）和 DBP（β=4.11，95%CI：1.08，7.13）有关。
COI 指标与青少年健康呈正相关。通过针对特定社区因素的社区干预和改善环境举措，青少年心血管疾病风险的差异可能是可以改变的。
