Health Status, Neighborhood Socioeconomic Context, and Premature Mortality in the United States: The National Institutes of Health-AARP Diet and Health Study
Health Status, Neighborhood Socioeconomic Context, and Premature Mortality in the United States: The National Institutes of Health-AARP Diet and Health Study
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DOI：
10.2105/ajph.2011.300158
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发表时间：
2012-04-01
影响因子：
12.7
通讯作者：
Schatzkin, Arthur
中科院分区：
文献类型：
--
作者：
Doubeni, Chyke A.;Schootman, Mario;Schatzkin, Arthur
目标.我们研究了与生活在社会经济贫困社区相关的过早死亡风险是否因个人健康状况而异。社区居住的成年人（n=566402;年龄=50-71岁）在美国6个州和2个大都市地区参加了正在进行的前瞻性国立卫生研究院-美国退休人员协会饮食和健康研究，开始于1995年。我们使用了565679名参与者的基线数据，包括健康行为、自评健康状况和病史，这些数据是通过邮寄问卷收集的。参与者与2000年人口普查数据相联系，以获得人口普查区域社会经济贫困指数。主要结局是2006年确定的全因死亡率。在对基线时健康状况良好至极佳的人进行的调整后生存分析中，死亡风险随着人口普查区域社会经济贫困程度的增加而增加。在调整了人口统计学特征、教育成就、生活方式和医疗条件后，健康状况从好到差的人群之间的社区社会经济死亡率差异没有统计学意义。社区社会经济不平等导致健康美国成年人过早死亡风险的巨大差异，但健康状况不佳的人则不然。(Am J公共卫生。2012;102：680-688. doi：10.2105/AJPH.2011.300158）
Objectives. We examined whether the risk of premature mortality associated with living in socioeconomically deprived neighborhoods varies according to the health status of individuals.Methods. Community-dwelling adults (n=566402; age=50-71 years) in 6 US states and 2 metropolitan areas participated in the ongoing prospective National Institutes of Health-AARP Diet and Health Study, which began in 1995. We used baseline data for 565679 participants on health behaviors, self-rated health status, and medical history, collected by mailed questionnaires. Participants were linked to 2000 census data for an index of census tract socioeconomic deprivation. The main outcome was all-cause mortality ascertained through 2006.Results. In adjusted survival analyses of persons in good-to-excellent health at baseline, risk of mortality increased with increasing levels of census tract socioeconomic deprivation. Neighborhood socioeconomic mortality disparities among persons in fair-to-poor health were not statistically significant after adjustment for demographic characteristics, educational achievement, lifestyle, and medical conditions.Conclusions. Neighborhood socioeconomic inequalities lead to large disparities in risk of premature mortality among healthy US adults but not among those in poor health. (Am J Public Health. 2012;102:680-688. doi:10.2105/AJPH.2011.300158)