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脆弱性还是恢复力?纽约市布朗克斯区墨西哥移民在 COVID-19 之前和期间与血糖水平相关的社会网络因素的两波面板分析。

Vulnerability or Resiliency? A Two-Wave Panel Analysis of Social Network Factors Associated with Glycemic Levels among Mexican Immigrants in the Bronx, NYC, Before and During COVID-19.

机构信息

Environmental, Occupational and Geospatial Sciences Department, City University of New York (CUNY), CUNY Graduate School of Public Health and Heath Policy, 55 West 125th Street, New York, NY, 10027, USA.

Center for Systems and Community Design, New York, NY, USA.

出版信息

J Urban Health. 2024 Feb;101(1):218-228. doi: 10.1007/s11524-023-00825-9. Epub 2024 Feb 12.

Abstract

Latinos have high rates of type 2 diabetes mellitus (T2DM) yet are characterized as having health-promoting social networks. The impacts of COVID-19 on personal networks were complex, especially in urban areas with high proportion of immigrants such as the Bronx in NYC. Our objective was to test the extent to which network characteristics increase vulnerability or resiliency for glycemic control based on data gathered from Mexican-origin Bronx dwellers. We used two-wave panel study analyzing self-reported personal social networks (n=30; 600) and HbA1c levels via dried blood spots in 2019, before the COVID-19 pandemic, and in 2021, a time after initial lockdowns and when the pandemic was still ravaging the community of study. Regression models adjusted for individual-level variables including sociodemographic and health indicators (i.e., physical health including COVID-19 and mental health). We found that an increase in the proportion of network members with diabetes predicted an increase in participant's HbA1c levels from 2019 to 2021 (β=0.044, p < 0.05). Also, a greater proportion of network members consuming "an American diet" in 2019 predicted a decrease in participant's HbA1c levels (β=-0.028, p < 0.01), while a greater proportion of network members that encouraged participants' health in 2019 predicted an increase in participant's HbA1c levels (β=0.033, p < 0.05). Our study sheds light on specific social network characteristics relevant to individual diabetes outcomes, including potential longitudinal mechanistic effects that played out at the peak of the COVID-19 crisis.

摘要

拉丁裔人群 2 型糖尿病(T2DM)发病率较高,但他们具有促进健康的社交网络。COVID-19 对个人网络的影响较为复杂,尤其是在像纽约市布朗克斯区这样移民比例较高的城市。我们的目的是基于从居住在布朗克斯区的墨西哥裔美国人那里收集的数据,检验网络特征在多大程度上增加了血糖控制的脆弱性或弹性。我们使用了两波面板研究,分析了自我报告的个人社交网络(n=30;600)和 2019 年(COVID-19 大流行之前)和 2021 年(首次封锁后和大流行仍在肆虐研究社区时)通过干血斑测量的糖化血红蛋白(HbA1c)水平。回归模型调整了个体水平变量,包括社会人口统计学和健康指标(即包括 COVID-19 在内的身体健康和心理健康)。我们发现,2019 年网络中患有糖尿病的成员比例增加预示着参与者的 HbA1c 水平从 2019 年到 2021 年的增加(β=0.044,p < 0.05)。此外,2019 年网络中更多成员食用“美式饮食”预示着参与者的 HbA1c 水平下降(β=-0.028,p < 0.01),而 2019 年网络中更多鼓励参与者健康的成员预示着参与者的 HbA1c 水平增加(β=0.033,p < 0.05)。我们的研究揭示了与个体糖尿病结果相关的特定社交网络特征,包括在 COVID-19 危机高峰期发挥作用的潜在纵向机制效应。

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