Does social cohesion mediate neighbourhood effects on mental and physical health? Longitudinal analysis using German Socio-Economic Panel data
Does social cohesion mediate neighbourhood effects on mental and physical health? Longitudinal analysis using German Socio-Economic Panel data
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DOI：
10.1186/s12889-020-09149-8
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发表时间：
2020-07-01
影响因子：
4.5
通讯作者：
Sauzet, Odile
中科院分区：
文献类型：
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作者：
Kress, Sara;Razum, Oliver;Sauzet, Odile
背景邻里关系已成为健康的相关决定因素。虽然有大量证据表明环境因素影响健康，但关于社会机制在邻里特征与健康之间因果链中的作用的证据却少之又少。 方法为了使用德国社会经济小组（SOEP）的数据评估社会凝聚力作为四种不同邻里特征与健康之间中介的作用，进行了纵向中介分析。根据社会经济变量调整的多级线性回归模型涉及三个时间点和两个身心健康指标（SF12 问卷的身心成分评分（PCS 和 MCS）。从 2004 年开始，对参与者进行了 4 年和 10 年的随访。结果 共纳入了居住在 4,985 个家庭的 10,013 名参与者的 15,518 项 MCS 和 PCS 测量值。调整了就基线和人口/社会经济变量而言，社会凝聚力是 MCS 和 PCS 的显着正向预测因子（β 系数 MCS：1.57 (0.27)；PCS：1.50 (0.24)）。社会凝聚力和随访之间的相互作用对 PCS 具有显着影响。环境和建筑特征对健康的影响始终由社会凝聚力介导，比例在 10% 到 23% 之间变化。社会凝聚力是社区环境特征和建筑特征与健康之间因果链的一部分，随着时间的推移，对身体健康的中介作用不断增强，在研究社区特征对健康不平等的影响时，应考虑社会机制，使社会凝聚力成为社区层面公共卫生干预的合法目标。
BackgroundNeighbourhood has risen as a relevant determinant of health. While there is substantial evidence that environmental factors affect health, far less evidence of the role of social mechanisms in the causal chain between neighbourhood characteristics and health is available.MethodTo evaluate the role of social cohesion as a mediator between four different neighbourhood characteristics and health using data from German Socio-Economic-Panel (SOEP), a longitudinal mediation analysis was performed. Multilevel linear regression models adjusted for socio-economic variables involved three time points and two measures of physical and mental health (physical and mental component scores (PCS and MCS) of the SF12 Questionnaire. Participants were followed-up for 4 and 10year starting in 2004.ResultsA total of 15,518 measures of MCS and PCS on 10,013 participants living in 4985 households were included. After adjusting for values of MCS and PCS at baseline and demographic/socio-economic variables, social cohesion was a significant positive predictor of both MCS and PCS (beta -coefficient MCS: 1.57 (0.27); PCS: 1.50 (0.24)). Interaction between social cohesion and follow-up were significant for PCS. The effect of environmental and built characteristics on health was consistently mediated by social cohesion with proportion varying between 10 and 23%.DiscussionWe show that social cohesion is part of the causal chain between environmental and built characteristics of a neighbourhood and health, with increasing mediation effect over time for physical health. Social mechanisms should be considered when studying the effect of neighbourhood characteristics on health inequalities making social cohesion as a legitimate target of public health interventions at neighbourhood level.