全国妇女健康研究 14 年中心血管代谢风险因素的邻里物理环境变化。
Neighborhood physical environments and change in cardiometabolic risk factors over 14 years in the study of Women's health across the nation.
机构信息
Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
出版信息
Health Place. 2024 May;87:103257. doi: 10.1016/j.healthplace.2024.103257. Epub 2024 May 1.
BACKGROUND
Neighborhood physical environments may influence cardiometabolic health, but prior studies have been inconsistent, and few included long follow-up periods.
METHODS
Changes in cardiometabolic risk factors were measured for up to 14 years in 2830 midlife women in the Study of Women's Health Across the Nation, a multi-ethnic/racial cohort of women from seven U.S. sites. Data on neighborhood food retail environments (modified Retail Food Environment Index) and walkability (National Walkability Index) were obtained for each woman's residence at each follow-up. Data on neighborhood access to green space, parks, and supermarkets were available for subsets (32-42%) of women. Models tested whether rates of change in cardiometabolic outcomes differed based on neighborhood characteristics, independent of sociodemographic and health-related covariates.
RESULTS
Living in more (vs. less) walkable neighborhoods was associated with favorable changes in blood pressure outcomes (SBP: -0.27 mmHg/year, p = 0.002; DBP: -0.22 mmHg/year, p < 0.0001; hypertension status: ratio of ORs = 0.79, p < 0.0001), and small declines in waist circumference (-0.09 cm/year, p = 0.03). Small-magnitude associations were also observed between low park access and greater increases in blood pressure outcomes (SBP: 0.37 mmHg/year, p = 0.003; DBP: 0.15 mmHg/year, p = 0.04; hypertension status: ratio of ORs = 1.16, p = .04), though associations involving DBP and hypertension were only present after adjustment for sociodemographic variables. Other associations were statistically unreliable or contrary to hypotheses.
CONCLUSION
Neighborhood walkability may have a meaningful influence on trajectories of blood pressure outcomes in women from midlife to early older adulthood, suggesting the need to better understand how individuals interact with their neighborhood environments in pursuit of cardiometabolic health.
背景
邻里物理环境可能会影响心脏代谢健康，但先前的研究结果并不一致，且很少有研究包含长期随访期。
方法
在全美妇女健康研究中，对 2830 名中年女性进行了长达 14 年的心脏代谢风险因素变化的测量，这是一项由美国七个地点的多民族/种族女性组成的队列研究。为每位女性在每次随访时的住所获得了邻里食品零售环境（改良后的零售食品环境指数）和步行性（国家步行性指数）的数据。对于 32-42%的女性，还有邻里获得绿色空间、公园和超市的情况的数据。模型测试了基于邻里特征的心脏代谢结果的变化率是否与社会人口统计学和健康相关的协变量无关。
结果
居住在步行环境更（差）的社区与血压结果的有利变化有关（SBP：-0.27 毫米汞柱/年，p=0.002；DBP：-0.22 毫米汞柱/年，p<0.0001；高血压状态：比值比=0.79，p<0.0001），腰围也略有下降（-0.09 厘米/年，p=0.03）。低公园可达性与血压结果的较大增加之间也存在小幅度关联（SBP：0.37 毫米汞柱/年，p=0.003；DBP：0.15 毫米汞柱/年，p=0.04；高血压状态：比值比=1.16，p=0.04），尽管与 DBP 和高血压相关的关联仅在调整社会人口统计学变量后才存在。其他关联则没有统计学意义或与假设相反。
结论
邻里的步行性可能对女性从中年到早期老年期的血压结果轨迹有重要影响，这表明需要更好地理解个体在追求心脏代谢健康时如何与他们的邻里环境相互作用。
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