人口普查区层面的高档化和收入不平等与西班牙裔社区健康研究/拉丁裔研究中代谢综合征 6 年发生率的关联：一项流行病学队列研究。
Association of census-tract level gentrification and income inequality with 6-year incidence of metabolic syndrome in the Hispanic Community Health Study/Study of Latinos, an epidemiologic cohort study.
机构信息
National Cancer Institute, National Institute of Health, 9609 Medical Center Drive, Rockville, MD 20815, USA; University of Illinois at Chicago, Department of Psychology, 1007 W Harrison St, Chicago, IL, 60607, USA.
Albert Einstein College of Medicine, 1300 Morris Park Ave, The Bronx, NY, 1046, USA.
出版信息
Soc Sci Med. 2023 Nov;336:116222. doi: 10.1016/j.socscimed.2023.116222. Epub 2023 Sep 9.
BACKGROUND
Metabolic syndrome varies by socio-demographic characteristics, with younger (18-29 years) and older (50-69 years) Hispanic/Latino having higher prevalence compared to other groups. While there is substantial research on neighborhood influences on cardiometabolic health, there are mixed findings regarding the effects of gentrification and few studies have included Hispanic/Latinos. The role of neighborhood income inequality on metabolic health remains poorly understood.
OBJECTIVES
Examined associations of neighborhood gentrification and income inequality with metabolic syndrome (MetSyn) using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
DESIGN, SETTING AND PARTICIPANTS: The HCHS/SOL is a community-based cohort of adults of Hispanic/Latinos (aged 18-74). Analyses included 6710 adults who did not meet criteria for MetsS at baseline (2008-2011) and completed the visit 2 examination (2014-2017). Poisson regressions estimated odds ratios (IRR) and 95% confidence intervals (CI) for neighborhood gentrification and change in income inequality with MetSyn incidence.
MAIN OUTCOME AND EXPOSURE MEASURES
Gentrification was measured with an index that included changes (2000 to 2006-2010) in education, poverty, and income. Change in neighborhood income inequality (2005-2009 to 2012-2016) was measured using the Gini coefficient of income distribution. MetSyn was defined using National Cholesterol Education Program Adult Treatment Panel III criteria.
RESULTS
Among 6647 Hispanic/Latino adults, 23% (N = 1530) had incident MetSyn. In models adjusted for socio-demographic, health insurance status, and neighborhood characteristics, gentrification (IRR, 1.00, 95%CI, 0.96-1.03) and income inequality change (IRR, 1.00, 95%CI, 0.99-1.00) were not associated with MetSyn at visit 2. There was no association between cross-sectional income inequality (2005-2009) and MetSyn at visit 2 (IRR, 0.97, 95%CI, 0.82-1.15).
CONCLUSION
Neighborhood gentrification and income inequality change were not associated with incidence of MetSyn over 6 years among Hispanic/Latino adults. This study demonstrated that income-based residential changes alone may not be sufficient to explain neighborhood influences on health outcomes among this population.
背景
代谢综合征因社会人口特征而异，与其他人群相比，年轻（18-29 岁）和年老（50-69 岁）的西班牙裔/拉丁裔人群的患病率更高。虽然有大量关于邻里对心脏代谢健康影响的研究，但关于 gentrification 的研究结果存在差异，而且很少有研究包括西班牙裔/拉丁裔人群。邻里收入不平等对代谢健康的影响仍知之甚少。
目的
使用来自西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）的数据，研究邻里 gentrification 和收入不平等与代谢综合征（MetSyn）之间的关联。
设计、地点和参与者：HCHS/SOL 是一项针对西班牙裔/拉丁裔成年人（年龄在 18-74 岁之间）的社区为基础的队列研究。分析包括 6710 名在基线（2008-2011 年）时不符合 MetsS 标准且完成了 2 次就诊检查（2014-2017 年）的成年人。泊松回归估计了 gentrification 和收入不平等变化与 MetSyn 发生率之间的比值比（IRR）和 95%置信区间（CI）。
主要结果和暴露测量
gentrification 用一个包含教育、贫困和收入变化的指数来衡量。邻里收入不平等变化（2005-2009 年至 2012-2016 年）使用收入分配基尼系数来衡量。MetSyn 采用国家胆固醇教育计划成人治疗专家组 III 标准定义。
结果
在 6647 名西班牙裔/拉丁裔成年人中，有 23%（N=1530）发生了新的 MetSyn。在调整了社会人口统计学、医疗保险状况和邻里特征后，gentrification（IRR，1.00，95%CI，0.96-1.03）和收入不平等变化（IRR，1.00，95%CI，0.99-1.00）与第二次就诊时的 MetSyn 无关。横断面收入不平等（2005-2009 年）与第二次就诊时的 MetSyn 之间没有关联（IRR，0.97，95%CI，0.82-1.15）。
结论
在西班牙裔/拉丁裔成年人中，邻里 gentrification 和收入不平等变化与 MetSyn 的 6 年发病率无关。这项研究表明，仅基于收入的居住变化可能不足以解释该人群中邻里对健康结果的影响。
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