Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA.
Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA.
Environ Res. 2021 Nov;202:111704. doi: 10.1016/j.envres.2021.111704. Epub 2021 Jul 17.
Individual-level socioeconomic status (SES) has been shown to be an important determinant of lung function. Neighborhood level SES factors may increase psychological and physiologic stress and may also reflect other exposures that can adversely affect lung function, but few studies have considered neighborhood factors.
Our aim was to assess the association between neighborhood-level SES and lung function.
We cross-sectionally analyzed 6168 spirometry test results from participants in the Gulf long-term Follow-up Study, a large cohort of adults enrolled following the largest maritime oil spill in US history. Outcomes of interest included the forced expiratory volume in 1 s (FEV; mL), the forced vital capacity (FVC; mL), and the FEV/FVC ratio (%). Neighborhood deprivation was measured by linking participant home addresses to an existing Area Deprivation Index (ADI) and categorized into quartiles. Individual-level SES measures were collected at enrollment using a structured questionnaire and included income, educational attainment, and financial strain. We used multilevel regression to estimate associations between ADI quartiles and each lung function measure.
Greater neighborhood deprivation was associated with lower FEV: β: -30 mL (95% CI: -97, 36), β: -70 mL (95% CI: -135, -4) and β: -104 mL (95% CI: -171, -36). FVC showed similar patterns of associations with neighborhood deprivation. No associations with the FEV/FVC ratio were observed.
Neighborhood deprivation, a measure incorporating economic and other stressors, was associated with lower FEV and FVC, with magnitudes of associations reaching clinically meaningful levels. The impact of this neighborhood SES measure persisted even after adjustment for individual-level SES factors.
个体层面的社会经济地位（SES）已被证明是肺功能的重要决定因素。邻里层面的 SES 因素可能会增加心理和生理压力，也可能反映出其他可能对肺功能产生不利影响的暴露因素，但很少有研究考虑邻里因素。
我们旨在评估邻里层面的 SES 与肺功能之间的关系。
我们对海湾长期随访研究中的 6168 例肺活量测定试验结果进行了横断面分析，该研究是美国历史上最大的海上石油泄漏事件后纳入的一个大型成年队列。感兴趣的结局指标包括 1 秒用力呼气量（FEV；毫升）、用力肺活量（FVC；毫升）和 FEV/FVC 比值（%）。通过将参与者的家庭住址与现有的区域剥夺指数（ADI）相联系来衡量邻里剥夺程度，并将其分为四分位数。个体层面的 SES 测量值在入组时通过结构化问卷收集，包括收入、教育程度和经济压力。我们使用多水平回归来估计 ADI 四分位数与每个肺功能指标之间的关联。
更高的邻里剥夺程度与较低的 FEV 相关：β：-30 毫升（95%置信区间：-97，36），β：-70 毫升（95%置信区间：-135，-4）和 β：-104 毫升（95%置信区间：-171，-36）。FVC 与邻里剥夺之间也存在类似的关联模式。与 FEV/FVC 比值没有观察到关联。
包含经济和其他压力源的邻里剥夺程度与较低的 FEV 和 FVC 相关，关联程度达到了有临床意义的水平。即使在调整了个体层面的 SES 因素后，这种邻里 SES 测量值的影响仍然存在。
