邻里劣势对以芝加哥为基地、主要为非裔美国人的队列中哮喘患病率的影响。
The Impact of Neighborhood Disadvantage on Asthma Prevalence in a Predominantly African-American, Chicago-Based Cohort.
作者信息
Luo Jiajun, Kibriya Muhammad G, Shah Sameep, Craver Andrew, De La Cruz Sebastian, King Jaime, Olopade Christopher O, Kim Karen, Ahsan Habibul, Pinto Jayant, Aschebrook-Kilfoy Briseis
出版信息
Am J Epidemiol. 2023 Apr 6;192(4):549-559. doi: 10.1093/aje/kwad015.
This study aimed to investigate the joint effect of neighborhood disadvantages on asthma prevalence and evaluate whether individual-level variables protect residents against neighborhood disadvantages. Data from the Chicago Multiethnic Prevention and Surveillance Study (from 2013-2020) were analyzed. Eight neighborhood characteristics were measured using the Chicago Health Atlas, including neighborhood unsafety, limited access to healthy food, neighborhood alienation, severe rent burden, vacant housing, single-parent household, neighborhood poverty, and unemployment. A structured questionnaire measured asthma diagnosis (childhood or adulthood) and individual-level variables including sex, age, income, education, and race. Weighted quantile sum (WQS) regression was used to evaluate the impact of neighborhood disadvantages. Stratified analysis was performed by income and education. A total of 6,592 participants (mean age = 53.5 (standard deviation, 11.1) years) were included. Most of the study population were non-Hispanic Black (82.5%) and reported an annual household income less than $15,000 (53%). Asthma prevalence was 23.6%. The WQS index, which represents the overall neighborhood disadvantages, was associated with asthma prevalence (odds ratio = 1.14, 95% confidence interval: 1.07, 1.22) when adjusted for individual-level confounders. Neighborhood poverty contributed 40.8% to the overall impact, followed by vacant housing (23.1%) and neighborhood alienation (22.9%). When stratified by individual-level income or education, no difference was observed for the association between WQS index and asthma prevalence.
本研究旨在调查邻里劣势对哮喘患病率的联合影响,并评估个体层面的变量是否能保护居民免受邻里劣势的影响。分析了来自芝加哥多民族预防与监测研究(2013 - 2020年)的数据。使用芝加哥健康地图集测量了八个邻里特征,包括邻里不安全、健康食品获取受限、邻里疏离、严重租金负担、空置住房、单亲家庭、邻里贫困和失业。一份结构化问卷测量了哮喘诊断(儿童期或成年期)以及包括性别、年龄、收入、教育程度和种族在内的个体层面变量。采用加权分位数和(WQS)回归来评估邻里劣势的影响。按收入和教育程度进行分层分析。共纳入6592名参与者(平均年龄 = 53.5(标准差,11.1)岁)。研究人群中大多数是非西班牙裔黑人(82.5%),且报告家庭年收入低于15,000美元(53%)。哮喘患病率为23.6%。在调整个体层面的混杂因素后,代表整体邻里劣势的WQS指数与哮喘患病率相关(优势比 = 1.14,95%置信区间:1.07,1.22)。邻里贫困对总体影响的贡献率为40.8%,其次是空置住房(23.1%)和邻里疏离(22.9%)。按个体层面的收入或教育程度分层时,未观察到WQS指数与哮喘患病率之间的关联存在差异。