A multilevel analysis of urban neighborhood socioeconomic disadvantage and health in late life
A multilevel analysis of urban neighborhood socioeconomic disadvantage and health in late life
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DOI：
10.1016/j.socscimed.2007.11.002
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发表时间：
2008-02-01
影响因子：
5.4
通讯作者：
Aneshensel, Carol S.
中科院分区：
文献类型：
--
作者：
Wight, Richard G.;Cummings, Janet R.;Aneshensel, Carol S.
邻里环境和健康的各种指标之间的关联正在受到越来越多的实证关注，但这种研究的大部分是区域限制或假设在整个生命过程中的类似效果。本研究利用美国全国样本调查城市社区社会经济劣势与老年人健康之间的关联。数据来自3442名70岁及以上的参与者，他们参加了1993年最年长者资产和健康动态研究（AHEAD）和1990年美国人口普查。我们的方法强调了健康的多个维度（自我报告的医生诊断的心血管疾病[CVD]，功能状态和自我评价的健康）以及邻里劣势的多个维度的重要性，这些维度被概念化为可能导致生理应激反应的环境危害。我们发现，个人层面的因素削弱邻里劣势和心血管疾病和功能状态之间的关联，但不是自评健康。净协变量，高邻里社会经济劣势与报告健康状况不佳显着相关。在晚年，邻里的社会经济不利因素对健康的主观评价比诊断出的心血管疾病或功能限制更重要。(C)2007爱思唯尔有限公司保留所有权利。
The associations between neighborhood context and various indicators of health are receiving growing empirical attention, but much of this research is regionally circumscribed or assumes similar effects across the life course. This study utilizes a U.S. national sample to investigate the association between urban neighborhood socioeconomic disadvantage and health specifically among older adults. Data are from 3442 participants aged 70 years and older in the 1993 Asset and Health Dynamics Among the Oldest Old (AHEAD) Study, and the 1990 U.S. Census. Our approach underscores the importance of multiple dimensions of health (self-reported physician-diagnosed cardiovascular disease [CVD], functional status, and self-rated health) as well as multiple dimensions of neiahborhood disadvantage, which are conceptualized as environmental hazards that may lead to a physiologically consequential stress response. We find that individual-level factors attenuate the association between neighborhood disadvantage and both CVD and functional status, but not self-rated health. Net of covariates, high neighborhood socioeconomic disadvantage is significantly associated with reporting poor health. In late life, neighborhood socioeconomic disadvantage is more consequential to subjective appraisals of health than diagnosed CVD or functional limitations. (C) 2007 Elsevier Ltd. All rights reserved.