Del Brutto Oscar H, Mera Robertino M, Del Brutto Victor J, Rumbea Denisse A, Arias Emilio E, Sedler Mark J
Universidad Espíritu Santo-Ecuador, Samborondón, Ecuador.
Freenome, Inc., South San Francisco, CA, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241305951. doi: 10.1177/21501319241305951.
Street violence has detrimental effects on cardiovascular health (CVH). However, the significance of these consequences have not been systematically evaluated. In this study, we aimed to assess the impact of fear of crime on CVH status among community-dwellers aged ≥40 years living in a rural village stricken by violence.
Participants were selected from individuals enrolled in the Atahualpa Project Cohort, a population-based longitudinal study that aims to reduce the burden of cardiovascular risk factors and diseases in rural Ecuador. Fear of crime was evaluated using a structured scale. The Life's Simple 7 construct of the American Heart Association was employed to assess CVH before the escalation of violence and crime in the village (2019) and at the end of the study (2024). Multivariate logistic regression models were fitted to examine the association between the exposure and outcomes.
A total of 648 individuals (mean age = 57.4 ± 11.7 years; 56% women) were included. At the end of the follow-up, significant association between fear of crime levels and worsening CVH status was noted. Participants allocated to the second and third tertiles of fear of crime were 3.27 (95% CI = 2.07-5.19) and 5.46 (95% CI = 3.14-9.48) times more likely to have worsening CVH status at follow-up compared to baseline determinations, respectively.
This study shows an aggravating impact of fear of crime on the CVH status and identifies interventional targets that may help to reduce the risk of CVH status worsening in community-dwellers living in rural settings afflicted by violence.
街头暴力对心血管健康（CVH）有不利影响。然而，这些后果的重要性尚未得到系统评估。在本研究中，我们旨在评估犯罪恐惧对居住在遭受暴力侵袭的乡村中年龄≥40岁的社区居民心血管健康状况的影响。
参与者选自阿塔瓦尔帕项目队列中的个体，该队列是一项基于人群的纵向研究，旨在减轻厄瓜多尔农村地区心血管危险因素和疾病的负担。使用结构化量表评估犯罪恐惧。采用美国心脏协会的“生命简单7项指标”来评估该村暴力和犯罪升级前（2019年）以及研究结束时（2024年）的心血管健康状况。采用多变量逻辑回归模型来检验暴露因素与结局之间的关联。
共纳入648名个体（平均年龄=57.4±11.7岁；56%为女性）。在随访结束时，发现犯罪恐惧水平与心血管健康状况恶化之间存在显著关联。与基线测定相比，处于犯罪恐惧第二和第三三分位数的参与者在随访时心血管健康状况恶化的可能性分别高出3.27倍（95%置信区间=2.07-5.19）和5.46倍（95%置信区间=3.14-9.48）。
本研究显示了犯罪恐惧对心血管健康状况的加剧影响，并确定了可能有助于降低生活在受暴力影响农村地区的社区居民心血管健康状况恶化风险的干预目标。
