Neighborhood of residence and incidence of coronary heart disease.
Neighborhood of residence and incidence of coronary heart disease.
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DOI：
10.1056/nejm200107123450205
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发表时间：
2001-07-12
影响因子：
158.5
通讯作者：
Watson, RL
中科院分区：
文献类型：
--
作者：
Roux, AVD;Merkin, SS;Watson, RL
背景资料：一个人的生活通常不被认为是一个独立的预测他或她的健康，虽然居住地的物理和社会功能可能会影响健康和健康相关的behaviors.Methods：使用数据的动脉粥样硬化风险在社区研究，我们研究了特征的邻里之间的关系和冠心病的发病率。参与者的基线年龄为45至64岁，从美国的四个研究地点取样：北卡罗来纳州的福赛斯县;密西西比的杰克逊;明尼阿波利斯的西北郊区;和马里兰州的华盛顿县。作为社区的代理，我们使用了平均包含1000人的街区组，如美国人口普查所定义的。我们为每个社区的社会经济环境构建了一个汇总评分，其中包括财富和收入，教育和职业等信息。结果：在中位数为9.1年的随访期间，13，009名参与者发生了615起冠状动脉事件。即使在我们控制了个人收入、教育和职业之后，弱势社区的居民（那些综合得分较低的人）比弱势社区的居民有更高的患病风险。与生活在最贫困社区的高收入人群相比，生活在最贫困社区的低收入人群患冠心病的风险比在白人中为3.1（95%置信区间为2.1 ~ 4.8），在黑人中为2.5（95%置信区间为1.4 ~ 4.5）。这些协会保持不变后，调整冠心病的危险因素。结论：即使在控制个人收入，教育和职业，我们发现，生活在一个弱势社区与冠心病的发病率增加。（N Engl J Med 2001;345：99-106.）版权所有（C）2001马萨诸塞州医学会。
Background: Where a person lives is not usually thought of as an independent predictor of his or her health, although physical and social features of places of residence may affect health and health-related behavior.Methods: Using data from the Atherosclerosis Risk in Communities Study, we examined the relation between characteristics of neighborhoods and the incidence of coronary heart disease. Participants were 45 to 64 years of age at base line and were sampled from four study sites in the United States: Forsyth County, North Carolina; Jackson, Mississippi; the northwestern suburbs of Minneapolis; and Washington County, Maryland. As proxies for neighborhoods, we used block groups containing an average of 1000 people, as defined by the U.S. Census. We constructed a summary score for the socioeconomic environment of each neighborhood that included information about wealth and income, education, and occupation.Results: During a median of 9.1 years of follow-up, 615 coronary events occurred in 13,009 participants. Residents of disadvantaged neighborhoods (those with lower summary scores) had a higher risk of disease than residents of advantaged neighborhoods, even after we controlled for personal income, education, and occupation. Hazard ratios for coronary heart disease among low-income persons living in the most disadvantaged neighborhoods, as compared with high-income persons in the most advantaged neighborhoods, were 3.1 among whites (95 percent confidence interval, 2.1 to 4.8) and 2.5 among blacks (95 percent confidence interval, 1.4 to 4.5). These associations remained unchanged after adjustment for established risk factors for coronary heart disease.Conclusions: Even after controlling for personal income, education, and occupation, we found that living in a disadvantaged neighborhood is associated with an increased incidence of coronary heart disease. (N Engl J Med 2001;345:99-106.) Copyright (C) 2001 Massachusetts Medical Society.