Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Health Place. 2023 Nov;84:103128. doi: 10.1016/j.healthplace.2023.103128. Epub 2023 Oct 14.
Neighborhood socioeconomic disadvantage is associated with cardiovascular health, although it is unclear which specific aspects of neighborhoods matter most. We leveraged a natural experiment in which refugees to Denmark were quasi-randomly assigned to neighborhoods across the country during 1986-1998, creating variation in exposure to various aspects of neighborhood disadvantage. The cohort was followed through December 2018. Exposures included neighborhood-level family income, educational attainment, unemployment, and welfare transfers measured in the first neighborhood after arrival to Denmark. Outcomes included cardiovascular risk factors (hyperlipidemia, hypertension, diabetes and anxiety/depression) and cardiovascular disease (acute myocardial infarction and ischemic heart disease). Neighborhood-level income and education were most consistently associated with cardiovascular risk factors, whereas welfare transfers were most consistently associated with cardiovascular disease. Addressing these specific aspects of neighborhood disadvantage could therefore lower the risk of poor cardiovascular health among refugees. Future research is warranted to examine if results are generalizable to other immigrant groups, countries or time periods.
社区社会经济劣势与心血管健康有关，尽管尚不清楚社区的哪些具体方面最重要。我们利用了一项自然实验，在该实验中，1986 年至 1998 年期间，丹麦的难民被准随机分配到全国各地的社区，从而使他们接触到各种社区劣势方面的情况有所不同。该队列一直随访到 2018 年 12 月。暴露因素包括抵达丹麦后的第一个社区的邻里层面家庭收入、教育程度、失业和福利转移情况。结果包括心血管危险因素（血脂异常、高血压、糖尿病和焦虑/抑郁）和心血管疾病（急性心肌梗死和缺血性心脏病）。邻里层面的收入和教育与心血管危险因素的关系最一致，而福利转移与心血管疾病的关系最一致。因此，解决这些特定的社区劣势方面的问题可以降低难民不良心血管健康的风险。需要进一步研究以检验这些结果是否适用于其他移民群体、国家或时间段。
