生活在不健康的社区会影响个人的就业状况。
Living in an unhealthy neighbourhood impacts individual employment status.
作者信息
Ots Patricia, van Zon Sander K R, Mierau Jochen O, Brouwer Sandra
机构信息
Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
Faculty of Economics and Business, University of Groningen, Groningen, the Netherlands.
出版信息
BMC Public Health. 2025 Jul 2;25(1):2267. doi: 10.1186/s12889-025-23345-4.
OBJECTIVES
Individual characteristics including poor health are well-known to affect labour market participation. However, less is known on the role of health at the residential neighbourhood level. This study examines cross-sectional and longitudinal associations between neighbourhood health and employment status and the moderating role of individual health in the association between neighbourhood health and employment status.
METHODS
Individual level data from the Lifelines Cohort Study (n = 137,921) was matched with full-population neighbourhood health data and registry data from Statistics Netherlands on employment status with up to 14 years of follow-up. Neighbourhood health indicators included the proportion of individuals in poor self-reported health (nHealth) and with a chronic disease (nDisease) within neighbourhoods, divided in tertiles (T1, T2, T3). Individual health included dichotomized measures of self-reported poor health (iHealth) and the presence of a chronic disease (iDisease). Employment status comprised the categories employed, unemployed, work disabled, economically inactive and early retired. Logistic and cause-specific Cox regression analyses, including interaction terms between iHealth and nHealth, were used to examine the associations with employment status.
RESULTS
Poorest nHealth and nDisease tertiles were associated with higher risks of unemployment and work disability. Cross-sectional odds ratios (OR)s for nHealth T3 were: 2.22 (95% CI: 2.06─2.39) for unemployment and 1.98 (95% CI: 1.81─2.16) for work disability. Longitudinal hazard ratios (HR)s for nHealth T3 were: 1.27 (95% CI: 1.22─1.32) for unemployment and 1.59 (95% CI: 1.45─1.74) for work disability. Associations for nDisease were weaker but statistically significant. iHealth and iDisease moderated the associations but stratified analyses yielded inconclusive results.
CONCLUSIONS
Neighbourhood health promotion may have societal and economic benefits by extending individual's working lives.
目的
众所周知，包括健康状况不佳在内的个人特征会影响劳动力市场参与度。然而，关于健康在居住社区层面的作用，我们了解得较少。本研究考察了社区健康与就业状况之间的横断面和纵向关联，以及个人健康在社区健康与就业状况关联中的调节作用。
方法
生命线队列研究的个体层面数据（n = 137,921）与全人口社区健康数据以及荷兰统计局关于就业状况的登记数据进行匹配，随访时间长达14年。社区健康指标包括社区内自我报告健康状况不佳的个体比例（nHealth）和患有慢性病的个体比例（nDisease），分为三分位数（T1、T2、T3）。个人健康包括自我报告健康状况不佳的二分法测量指标（iHealth）和患有慢性病的情况（iDisease）。就业状况包括就业、失业、工作残疾、经济不活跃和提前退休等类别。使用逻辑回归和特定病因的Cox回归分析，包括iHealth和nHealth之间的交互项，来考察与就业状况的关联。
结果
nHealth和nDisease最差的三分位数与失业和工作残疾的较高风险相关。nHealth T3的横断面优势比（OR）分别为：失业2.22（95% CI：2.06─2.39），工作残疾1.98（95% CI：1.81─2.16）。nHealth T3的纵向风险比（HR）分别为：失业1.27（95% CI：1.22─1.32），工作残疾1.59（95% CI：1.45─1.74）。nDisease的关联较弱但具有统计学意义。iHealth和iDisease调节了这些关联，但分层分析结果不明确。
结论
社区健康促进可能通过延长个人工作寿命而带来社会和经济效益。
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