Neighbourhood chronic stress and gender inequalities in hypertension among Canadian adults: a multilevel analysis
Neighbourhood chronic stress and gender inequalities in hypertension among Canadian adults: a multilevel analysis
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DOI：
10.1136/jech.2008.083303
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发表时间：
2010-08-01
影响因子：
6.3
通讯作者：
Glazier, Richard H.
中科院分区：
文献类型：
--
作者：
Matheson, Flora I.;White, Heather L.;Glazier, Richard H.
背景越来越多的文献关于“地方”对健康的影响的背景影响越来越多地表明，生活在社区与高水平的剥夺是与更糟糕的心血管疾病的结果;然而，很少有研究探讨是否邻里剥夺对男性和女性的心血管健康有不同的影响。本研究的目的是探讨性别差异之间的联系邻里剥夺和患病率的高血压之间的非制度化的加拿大adultes.Methods个人层面的数据从加拿大社区健康调查（2000-2005年）与2001年加拿大人口普查的地区一级数据相结合，以评估性别、结果在103419名被调查者中，有20705人（17.6%）报告患有高血压。在多水平模型中，邻里剥夺与高血压显著相关，在调整个人水平的人口统计学，社会经济学和生活方式特征后，这种影响仍然显着（OR 1.12，95%CI 1.10至1.15）。邻里剥夺似乎是女性高血压的一个更强的预测因子，例如，与生活在同一社区的男性和生活在最不贫困社区的女性相比，生活在高度贫困地区的女性报告患有高血压的可能性高10%。虽然在地区一级的贫困现象在减少各社区健康结果不平等方面是有效的，但旨在减少地区一级贫困现象的政策可能对男女的心血管健康产生不同的惠益。
Background A growing body of literature regarding the contextual influences of 'place' effects on health increasingly demonstrates that living in neighbourhoods with high levels of deprivation is associated with worse cardiovascular outcomes; however, little research has explored whether neighbourhood deprivation has a differential impact on the cardiovascular health of men and women. The purpose of this study was to explore gender differences in the association between neighbourhood deprivation and the prevalence of hypertension among non-institutionalised Canadian adults.Methods Individual-level data from the Canadian Community Health Survey (2000-2005) were combined with area-level data from the 2001 Canada Census to assess the relationship between gender, neighbourhood deprivation and hypertension using multilevel regression.Results Of the 103 419 respondents, 20 705 reported having hypertension (17.6%). In multilevel models, neighbourhood deprivation was significantly associated with hypertension and this effect remained significant after adjusting for individual-level demographic, socioeconomic and lifestyle characteristics (OR 1.12, 95% CI 1.10 to 1.15). Neighbourhood deprivation appears to be a stronger predictor of hypertension among women, such that women living in areas of high deprivation were 10% more likely to report having hypertension in comparison with men living in the same neighbourhoods and with women living in the least impoverished neighbourhoods.Conclusions Although future research is needed to determine whether interventions at the area-level are effective in reducing inequalities in health outcomes across neighbourhoods, policies aimed at reducing area-level deprivation may have a differential benefit on the cardiovascular health of men and women.