Neighborhood socioeconomic status, depression, and health status in the Look AHEAD (Action for Health in Diabetes) study.
Neighborhood socioeconomic status, depression, and health status in the Look AHEAD (Action for Health in Diabetes) study.
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DOI：
10.1186/1471-2458-11-349
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发表时间：
2011-05-19
影响因子：
4.5
通讯作者：
Look AHEAD Research Group
中科院分区：
文献类型：
--
作者：
Gary-Webb TL;Baptiste-Roberts K;Pham L;Wesche-Thobaben J;Patricio J;Pi-Sunyer FX;Brown AF;Jones-Corneille L;Brancati FL;Look AHEAD Research Group
抑郁和健康状况下降在糖尿病成人中很常见，但很少有研究调查与社会经济环境的关系。本研究的目的是评估社区水平的社会经济地位与健康状况和抑郁症之间的关系。在Look AHEAD（糖尿病健康行动）中，1010名参与者的基线个人水平数据，这是一项2型糖尿病成年人长期减肥试验，与2000年美国人口普查中的社区水平SES（生活在贫困以下的百分比）有关。因变量包括抑郁（Beck量表）和健康状况（医学结局研究（SF-36）量表）。多层次回归模型被用来同时考虑个人层面的年龄，性别，种族，教育，个人年收入和社区层面的SES。总体而言，参与者所在社区的贫困率各不相同，平均值= 11%（范围0-67%）。与社区贫困最低三分位数（最不贫困）的同行相比，最高三分位数（最贫困）的人在SF-36量表的角色限制（身体），角色限制（情感），身体功能，社会功能，心理健康和活力子量表上的得分显著较低。在评估SF-36综合评分时，居住在贫困程度较高的社区的人在身体健康方面的得分显著较低（β系数[β] = -1.90单位，95% CI：-3.40，-0.039）、心理健康（β = -2.92单位，-4.31，-1.53）和总体健康（β = -2.77单位，-4.21，-1.33）综合评分。在这组选定的减肥试验参与者中，较低的社区SES与较差的健康状况显著相关。这些关联是否会影响对Look AHEAD减肥干预的反应，需要进一步调查。
Depression and diminished health status are common in adults with diabetes, but few studies have investigated associations with socio-economic environment. The objective of this manuscript was to evaluate the relationship between neighborhood-level SES and health status and depression. Individual-level data on 1010 participants at baseline in Look AHEAD (Action for Health in Diabetes), a trial of long-term weight loss among adults with type 2 diabetes, were linked to neighborhood-level SES (% living below poverty) from the 2000 US Census (tracts). Dependent variables included depression (Beck Inventory), and health status (Medical Outcomes Study (SF-36) scale). Multi-level regression models were used to account simultaneously for individual-level age, sex, race, education, personal yearly income and neighborhood-level SES. Overall, the % living in poverty in the participants' neighborhoods varied, mean = 11% (range 0-67%). Compared to their counterparts in the lowest tertile of neighborhood poverty (least poverty), those in the highest tertile (most poverty) had significantly lower scores on the role-limitations(physical), role limitations(emotional), physical functioning, social functioning, mental health, and vitality sub-scales of the SF-36 scale. When evaluating SF-36 composite scores, those living in neighborhoods with more poverty had significantly lower scores on the physical health (β-coefficient [β] = -1.90 units, 95% CI: -3.40,-0.039), mental health (β = -2.92 units, -4.31,-1.53) and global health (β = -2.77 units, -4.21,-1.33) composite scores. In this selected group of weight loss trial participants, lower neighborhood SES was significantly associated with poorer health status. Whether these associations might influence response to the Look AHEAD weight loss intervention requires further investigation.
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影响因子：
4.5
作者：
Gary-Webb TL;Baptiste-Roberts K;Pham L;Wesche-Thobaben J;Patricio J;Pi-Sunyer FX;Brown AF;Jones L;Brancati FL;Look AHEAD Research Group
通讯作者：
Look AHEAD Research Group
影响因子：
4.8
作者：
Gary, Tiffany L.;Stark, Sarah A.;LaVeist, Thomas A.
通讯作者：
LaVeist, Thomas A.
影响因子：
5
作者：
Balfour, JL;Kaplan, GA
通讯作者：
Kaplan, GA
影响因子：
16.2
作者：
Roux, AVD;Jacobs, DR;Kiefe, CI
通讯作者：
Kiefe, CI
影响因子：
6.3
作者：
Winkleby, MA;Cubbin, C
通讯作者：
Cubbin, C