Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, United States.
Prevention Science Institute, University of Oregon, Eugene, OR, United States.
Front Public Health. 2021 Feb 15;9:585157. doi: 10.3389/fpubh.2021.585157. eCollection 2021.
Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition. In January 2018, 798 Hispanic/Latino adults ( age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability. After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability ( = -0.18, < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = -0.004, 95% CI [-0.01, -0.00]). Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.
人们对于感知邻里出行便捷程度与慢性病流行之间的联系知之甚少。对于西班牙裔/拉丁裔成年人，人们了解得更少，尽管他们患有慢性病的比例很高。种族歧视带来的压力是西班牙裔/拉丁裔人群健康的一个有害的社会决定因素。感知邻里出行便捷程度低和种族歧视压力高，可能会使西班牙裔/拉丁裔人群的慢性病状况恶化。在一项针对美国全国西班牙裔/拉丁裔成年人的横断面研究中，本研究旨在检验：(1)整体感知邻里出行便捷程度、种族歧视压力与患有慢性健康状况之间的关联；以及 (2)整体感知邻里出行便捷程度是否调节了种族歧视压力与患有慢性健康状况之间的假设关联。2018 年 1 月，798 名西班牙裔/拉丁裔成年人（年龄=39.7 岁，标准差=15.1；58.6%为女性；70.0%出生于美国；52.0%为墨西哥裔/墨西哥裔美国人）通过 Qualtrics Panels 回答了一项调查。调查包括邻里环境步行能力量表简表、西班牙裔压力量表-2 和自我报告的是否存在慢性健康状况（例如高血压、心脏病）。进行了 logistic 回归检验，以测试整体感知邻里出行便捷程度对种族歧视压力对慢性健康状况存在的主要影响的调节作用。在控制年龄、体重指数和收入后，种族歧视压力与整体感知邻里出行便捷程度呈负相关（= -0.18，< 0.001），与患有慢性健康状况呈正相关（OR=1.02；95%CI[1.00，1.03]）。虽然整体感知邻里出行便捷程度与患有慢性健康状况无关，但感知犯罪安全与患有慢性健康状况呈负相关（OR=0.94；95%CI[0.89，0.99]）。感知犯罪安全调节了歧视压力与患有慢性健康状况之间的正相关关系，以至于这种关联仅在那些认为自己所在社区不安全的人身上才具有统计学意义（β= -0.004，95%CI[-0.01，-0.00]）。整体感知邻里出行便捷程度与种族歧视压力呈负相关，但与患有慢性健康状况无关。感知邻里犯罪安全（而非基础设施或美观）对于西班牙裔/拉丁裔人群中种族歧视压力与患有慢性健康状况之间的联系至关重要。
