Neighbourhood characteristics and mortality in the atherosclerosis risk in communities study
Neighbourhood characteristics and mortality in the atherosclerosis risk in communities study
复制标题
DOI：
10.1093/ije/dyh063
复制
发表时间：
2004-04-01
影响因子：
7.7
通讯作者：
Clark, BL
中科院分区：
文献类型：
--
作者：
Borrell, LN;Roux, AVD;Clark, BL
背景本研究调查了社区动脉粥样硬化风险研究（ARIC）中邻里特征与死亡率（全因、心血管疾病和癌症）之间的关系，分析仅限于非裔美国人和白色参与者，基线年龄为45-64岁，其记录与人口普查数据有关。分析包括了截至1999年12月31日查明的死亡人数。从基线访谈中获得个人水平的特征。一个综合指数被用来描述邻里的社会经济环境。比例风险回归估计的影响，邻里社会经济地位（SES）指数和家庭收入的生存time.Results调整年龄和性别的死亡率是最高的那些谁住在贫困社区和较低的SES。总的来说，在所有种族性别组中，全因死亡率和心血管疾病死亡率随着社区SES优势和家庭收入的增加而下降。尽管在调整个体社会经济因素后，这种模式通常持续存在，但仅白人CVD死亡率存在统计学显著相关性（最弱势人群与最弱势人群的风险比= 1.4，95%CI：1.0，2.0）。与生活在最贫困社区的最富裕参与者相比，与贫困和生活在最贫困社区相关的全因和心血管疾病死亡率增加的风险相当于白人和非裔美国人基线时的11岁和13岁，结论社区社会经济特征与CVD死亡率的适度增加有关在白色成年人中。由于这些参与者所来自的邻里特征范围有限，因此需要谨慎解释非裔美国人缺乏邻里效应。
Background This study investigates the relationship between neighbourhood characteristics and mortality (all-cause, cardiovascular disease [CVD], and cancer) in the Atherosclerosis Risk in Communities Study (ARIC).Methods Analysis was limited to African-American and white participants 45-64 years of age at baseline whose records were linked to census data. Deaths ascertained through 31 December 1999 were included in the analysis. Individual-level characteristics were obtained from the baseline interview. A composite index was used to characterize the neighbourhood socioeconomic environment. Proportional hazards regression was used to estimate the effect of neighbourhood socioeconomic status (SES) index and family income on the survival time.Results The rate of mortality adjusted for age and gender was highest among those who lived in disadvantaged neighbourhoods and were of lower SES. In general, all-cause and CVD mortality rates decreased with increasing neighbourhood SES advantage and family income in all race-gender groups. Although this pattern generally persisted after adjustment for individual socioeconomic factors, statistically significant associations persisted for CVD mortality in whites only (hazard ratio = 1.4, 95% CI: 1.0, 2.0) for most disadvantaged versus most advantaged tertile). When compared with the most affluent participants living in the most advantaged neighbourhoods, the increased risk of all-cause and CVD mortality associated with being poor and living in the most disadvantaged neighbourhoods was equivalent to being 11 and 13 years older at baseline for whites and African Americans, respectively.Conclusion Our findings indicate that neighbourhood socioeconomic characteristics are associated with modest increases in CVD mortality in white adults. The lack of neighbourhood effects in African Americans needs to be interpreted with caution due to the limited range in the characteristics of the neighbourhood from which these participants were drawn.