Neighbourhood environment and its association with self rated health: evidence from Scotland and England
Neighbourhood environment and its association with self rated health: evidence from Scotland and England
复制标题
DOI：
10.1136/jech.2003.016147
复制
发表时间：
2005-03-01
影响因子：
6.3
通讯作者：
Ellaway, A
中科院分区：
文献类型：
--
作者：
Cummins, S;Stafford, M;Ellaway, A
设计：对英格兰健康调查和苏格兰健康调查抽样调查的13899名16岁或以上的男性和女性进行横断面研究，以提供多层次的数据。研究对象：来自英格兰健康调查(1994-99)和苏格兰健康调查(1995和1998)的13899名16岁或16岁以上的男性和女性。结果：中等到极差的自评健康与六个社区属性显著相关：居住环境质量差，左翼政治气候，低政治参与度，高失业率，获得私人交通工具的机会更少，交通财富也更低。这种联系不受性别、年龄、社会阶层和经济活动的影响。非就业居民的赔率比就业居民的要大。自评健康与其他五项邻里措施并无显著关联：公共娱乐设施、犯罪、卫生服务提供、食品店、银行和建筑协会。结论：邻里环境的某些特征与自评健康相关，可能是重要因果路径的指标，可为公共卫生干预策略提供重点。非就业居民的关联性更明显，可能是因为与就业人员相比，他们更多地暴露在当地环境中。将假定对健康生活很重要的当地地区的特征的具体措施付诸实施，在寻找地区效应方面提供了比一般剥夺措施更有针对性的办法。
Objectives: To investigate associations between measures of neighbourhood social and material environment and self rated health.Design: New contextual measures added to cross sectional study of a sample of people from the Health Survey for England and the Scottish Health Survey to provide multilevel data.Participants: 13 899 men and women aged 16 or over for whom data on self rated health were available from the Health Survey for England ( years 1994-99) and the Scottish Health Survey ( years 1995 and 1998).Results: Fair to very bad self rated health was significantly associated with six neighbourhood attributes: poor physical quality residential environment, left wing political climate, low political engagement, high unemployment, lower access to private transport, and lower transport wealth. Associations were independent of sex, age, social class, and economic activity. Odds ratios were larger for non-employed residents than for employed residents. Self rated health was not significantly associated with five other neighbourhood measures: public recreation facilities, crime, health service provision, access to food shops, or access to banks and buildings societies.Conclusions: Some, but not all, features of the neighbourhood environment are associated with self rated health and may be indicators of important causal pathways that could provide a focus for public health intervention strategies. Associations were more pronounced for non-employed residents, perhaps because of greater exposure to the local environment compared with employed people. Operationalising specific measures of the characteristics of local areas hypothesised to be important for living a healthy life provides a more focused approach than general measures of deprivation in the search for area effects.