Department of Native Hawaiian Health, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016B, Honolulu, HI 96813 (
Department of Quantitative Health Sciences, University of Hawai'i at Mānoa, Honolulu, Hawai'i.
Prev Chronic Dis. 2024 Feb 15;21:E11. doi: 10.5888/pcd21.220341.
Native Hawaiian people have higher rates of illness and death related to cardiovascular disease (CVD) than non-Hispanic White people. Research in other populations has shown that individual-level CVD risk factors (ie, high-fat diet, physical inactivity, obesity, and tobacco use) are associated with neighborhood characteristics (ie, social cohesion, walkability, availability of healthy food, and safety). This association has yet to be examined among Native Hawaiians.
We conducted a cross-sectional survey of community-dwelling Native Hawaiian people in 2020. Three multiple regression models and 1 logistic regression model were assessed. Each model included individual-level CVD risk factors, age, sex, education, income, and neighborhood characteristics.
The regression models for body mass index (BMI) and physical activity showed significant results. The BMI model (R = 0.22, F = 4.81, P < .001) demonstrated that age, sex, education level, physical activity, and percentage of fat in the diet were significantly related to BMI. The availability of healthy foods had a significant, independent relationship with BMI (standardized β = -1.47, SE = 0.53, P = .01). The physical activity model (R = 0.21, F = 4.46, P < .001) demonstrated that age, sex, education, and BMI were significantly related to physical activity. None of the neighborhood characteristics had significant, independent relationships to physical activity.
We found that neighborhood-level factors improved the model's ability to explain variance in BMI. Efforts to decrease BMI would benefit from improving the availability of healthy foods in neighborhoods, a finding supported by research in other populations.
与非西班牙裔白种人相比，夏威夷原住民患心血管疾病（CVD）相关疾病和死亡的比率更高。其他人群的研究表明，个体 CVD 风险因素（即高脂肪饮食、缺乏身体活动、肥胖和吸烟）与邻里特征（即社会凝聚力、可步行性、健康食品供应和安全性）有关。这种关联尚未在夏威夷原住民中进行过研究。
我们于 2020 年对居住在社区的夏威夷原住民进行了横断面调查。评估了 3 个多元回归模型和 1 个逻辑回归模型。每个模型都包括个体 CVD 风险因素、年龄、性别、教育程度、收入和邻里特征。
体重指数（BMI）和身体活动的回归模型显示出显著结果。BMI 模型（R = 0.22，F = 4.81，P <.001）表明，年龄、性别、教育程度、身体活动和饮食中脂肪的百分比与 BMI 显著相关。健康食品的供应与 BMI 呈显著的独立关系（标准化β=-1.47，SE=0.53，P=.01）。身体活动模型（R = 0.21，F = 4.46，P <.001）表明，年龄、性别、教育程度和 BMI 与身体活动显著相关。邻里特征没有与身体活动呈显著的独立关系。
我们发现，邻里水平因素提高了模型解释 BMI 差异的能力。减少 BMI 的努力将受益于改善邻里健康食品的供应，这一发现得到了其他人群研究的支持。
