Center for Health Disparities Research, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA.
Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA.
Int J Environ Res Public Health. 2023 Oct 27;20(21):6982. doi: 10.3390/ijerph20216982.
Area-based social disadvantage, which measures the income, employment, and housing quality in one's community, can impact an individual's health above person-level factors. A life course approach examines how exposure to disadvantage can affect health in later life. This systematic review aimed to summarize the approaches used to assess exposure to area-based disadvantage over a life course, specifically those that define the length and timing of exposure. We reviewed the abstracts of 831 articles based on the following criteria: (1) whether the abstract described original research; (2) whether the study was longitudinal; (3) whether area-based social disadvantage was an exposure variable; (4) whether area-based social disadvantage was assessed at multiple points; and (5) whether exposure was assessed from childhood to older adulthood. Zero articles met all the above criteria, so we relaxed the fifth criterion in a secondary review. Six studies met our secondary criteria and were eligible for data extraction. The included studies followed subjects from childhood into adulthood, but none assessed disadvantages in late life. The approaches used to assess exposure included creating a cumulative disadvantage score, conducting a comparison between life course periods, and modeling the trajectory of disadvantage over time. Additional research was needed to validate the methodologies described here, specifically in terms of measuring the impact of area-based social disadvantage on health.
基于区域的社会劣势，衡量一个人所在社区的收入、就业和住房质量，可能会对个人健康产生影响，超过个人层面的因素。生命历程方法研究了在生命历程中接触劣势会如何影响晚年的健康。本系统综述旨在总结评估生命历程中基于区域的劣势暴露的方法，特别是那些定义暴露的长度和时间的方法。我们根据以下标准审查了 831 篇摘要：（1）摘要是否描述了原始研究；（2）研究是否是纵向的；（3）基于区域的社会劣势是否是暴露变量；（4）基于区域的社会劣势是否在多个时间点进行评估；以及（5）暴露是否从儿童期评估到成年期。没有一篇文章完全符合上述标准，因此我们在二次审查中放宽了第五个标准。六项研究符合我们的次要标准，并有资格进行数据提取。纳入的研究跟踪了从儿童期到成年期的受试者，但没有一项研究评估了生命后期的劣势。评估暴露的方法包括创建累积劣势评分、在生命历程期间进行比较，以及对劣势随时间的轨迹进行建模。需要进一步研究来验证这里描述的方法，特别是在衡量基于区域的社会劣势对健康的影响方面。
