Neighborhood social environment and risk of death: multilevel evidence from the Alameda County Study.
Neighborhood social environment and risk of death: multilevel evidence from the Alameda County Study.
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社区社会环境和死亡风险：来自阿拉米达县研究的多层次证据。
DOI：
10.1093/oxfordjournals.aje.a009733
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发表时间：
1999
影响因子：
5
通讯作者：
Kaplan,GA
中科院分区：
文献类型：
--
作者：
Yen,IH;Kaplan,GA
最近的报告表明，居民区特征与健康状况之间存在重要联系，但大多数研究仅使用人口普查数据来衡量这些特征。目前的研究考察了整个社区社会环境对11年死亡风险的影响。在数据的基础上，构建了一个三分量的社区社会环境量表：1)商业商店；2)人口社会经济地位；3)环境/住房。1983年阿拉米达县研究浪潮的数据（n= 1129）和11年内的死亡数据采用两级逻辑回归模型进行分析。低社会环境社区居民经年龄和性别调整后的死亡风险较高（优势比= 1.58,95%可信区间为1.15-2.18）。即使考虑到个人收入水平、教育程度、种族/民族、感知健康状况、吸烟状况、体重指数和饮酒量等因素，社会环境较差的社区的死亡风险也明显较高。当对社区社会环境特征评分的每个组成部分进行单独检查时，发现每个组成部分都与较高的死亡风险相关，独立于个体风险因素。这些发现证明了区域特征作为健康风险因素的作用，并指出需要更加关注社区质量的意义和测量。流行病学杂志1999；149: 898 - 907。
Recent reports suggest the importance of associations between residential area characteristics and health status, but most research uses only census data to measure these characteristics. The current research examined the effect of overall neighborhood social environment on 11-year risk of death. On the basis of data, the authors developed a three-component neighborhood social environment scale: 1) commercial stores; 2) population socioeconomic status; and 3) environment/housing. Data from the 1983 wave of the Alameda County Study (n= 1,129) and deaths over 11 years were analyzed with two-level logistic regression models. Age- and sex-adjusted risk of death was higher for residents in low social environment neighborhoods (odds ratio = 1.58, 95% confidence interval 1.15–2.18). Mortality risks were significantly higher in neighborhoods with a low social environment, even after account was taken of individual income level, education, race/ethnicity, perceived health status, smoking status, body mass index, and alcohol consumption. When each component of the neighborhood social environment characteristics score was examined separately, each was found to be associated with higher risk for mortality, independent of individual risk factors. These findings demonstrate the role of area characteristics as a health risk factor and point to the need for more focused attention to the meaning and measurement of neighborhood quality. Am J Epidemiol 1999; 149: 898–907.