西班牙裔聚居密度可能对某些健康状况下的老年黑人和非西班牙裔白人具有保护作用：对支持和邻里机制的探索。
Hispanic Ethnic Density May Be Protective for Older Black/African American and Non-Hispanic White Populations for Some Health Conditions: An Exploration of Support and Neighborhood Mechanisms.
机构信息
Center for Border Health Disparities, Health Sciences, University of Arizona, Tucson, AZ, USA.
The Department of Psychology, College of Science, University of Arizona, Tucson, AZ, USA.
出版信息
Ann Behav Med. 2022 Jan 1;56(1):21-34. doi: 10.1093/abm/kaab014.
BACKGROUND AND PURPOSE
Hispanic ethnic density (HED) is associated with salubrious health outcomes for Hispanics, yet recent research suggests it may also be protective for other groups. The purpose of this study was to test whether HED was protective for other racial-ethnic groups. We tested whether social support or neighborhood social integration mediated the association between high HED and depressive symptoms (CES-D) and physical morbidity 5 years later. Lastly, we tested whether race-ethnicity moderated both main and indirect effects.
METHODS
We used Waves 1 (2005-2006), and 2 (2010-2011) from The National Social Life, Health, and Aging Project, a national study of older U.S. adults. Our sample was restricted to Wave 1 adults who returned at Wave 2, did not move from their residence between waves, and self-identified as Hispanic, non-Hispanic White (NHW), or non-Hispanic Black (NHB; n = 1,635). We geo-coded respondents' addresses to a census-tract and overlaid racial-ethnic population data. Moderated-mediation models using multiple imputation (to handle missingness) and bootstrapping were used to estimate indirect effects for all racial-ethnic categories.
RESULTS
Depressive symptoms were lower amongst racial-ethnic minorities in ethnically (Hispanic) dense neighborhoods; this effect was not stronger in Hispanics. HED was not associated with physical morbidity. Sensitivity analyses revealed that HED was protective for cardiovascular events in all racial-ethnic groups, but not arthritis, or respiratory disease. Social support and neighborhood social integration were not mediators for the association between HED and outcomes, nor were indirect effects moderated by race-ethnicity.
CONCLUSIONS
This study offers some evidence that HED may be protective for some conditions in older adults; however, the phenomena underlying these effects remains a question for future work.
背景与目的
西班牙裔人口密度（HED）与西班牙裔的健康结果有关，但最近的研究表明，它也可能对其他群体具有保护作用。本研究的目的是检验 HED 是否对其他种族群体具有保护作用。我们检验了社会支持或邻里社会融合是否在 HED 与五年后抑郁症状（CES-D）和身体发病之间的关联中起中介作用。最后，我们检验了种族是否调节了主要和间接效应。
方法
我们使用了来自美国全国社会生活、健康和老龄化项目的第 1 波（2005-2006 年）和第 2 波（2010-2011 年）的数据，这是一项针对美国老年人的全国性研究。我们的样本仅限于在第 2 波返回且在波间未搬家的第 1 波成年人，且自我认同为西班牙裔、非西班牙裔白人（NHW）或非西班牙裔黑人（NHB；n=1635）。我们将受访者的地址进行地理编码到普查区，并覆盖了种族人口数据。使用多重插补（处理缺失值）和自举法的调节中介模型用于估计所有种族类别的间接效应。
结果
在种族密集的（西班牙裔）社区中，少数族裔的抑郁症状较低；而西班牙裔的这种影响并不更强。HED 与身体发病无关。敏感性分析表明，HED 对所有种族群体的心血管事件具有保护作用，但对关节炎或呼吸道疾病没有保护作用。社会支持和邻里社会融合不是 HED 与结果之间关联的中介，种族也没有调节间接效应。
结论
本研究提供了一些证据表明 HED 可能对老年人的某些疾病具有保护作用；然而，这些效应背后的现象仍然是未来工作的一个问题。
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