Perceived neighborhood safety and incident mobility disability among elders: the hazards of poverty
Perceived neighborhood safety and incident mobility disability among elders: the hazards of poverty
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DOI：
10.1186/1471-2458-9-162
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发表时间：
2009-05-28
影响因子：
4.5
通讯作者：
Berkman, Lisa F.
中科院分区：
文献类型：
--
作者：
Clark, Cheryl R.;Kawachi, Ichiro;Berkman, Lisa F.
背景资料：我们调查了是否缺乏感知邻里安全，由于犯罪，或生活在高犯罪率的社区是与事件的老年人流动性残疾。我们假设，面对感知或测量的犯罪相关安全危害，低收入老年人和退休年龄老年人（65-74岁）出现行动障碍的风险最大。方法：我们在纽黑文老年人流行病学研究人群（EPESE）中进行了这项研究，这是一项针对纽黑文65岁及以上社区老年人的纵向队列研究，1982年的康涅狄格州从1982年开始，对老年人进行了访谈，以评估他们的行动能力（爬楼梯和步行半英里的能力），对社区安全的看法，由于犯罪，家庭年收入，生活方式特征（吸烟，饮酒，体育活动）以及慢性共病的存在。此外，我们收集了基线数据，从纽黑文登记报在1982年附近的犯罪事件，以衡量当地的犯罪率在人口普查区level.Results：在基线在1982年，1,884老年人没有行动不便。经过8年的随访，在收入低于联邦贫困线的退休年龄的老年人中，感知安全危险与行动能力残疾的风险增加相关（HR 1.56，95%CI 1.02 - 2.37）。在退休年龄且收入高于贫困线的老年人中，没有发现感知安全危险的影响。没有影响，生活在高犯罪率的社区（测量报纸报道）被发现在任何sub-group.Conclusion：感知安全隐患，由于邻里犯罪是与增加风险的事件流动性残疾的贫困老人接近退休年龄。与以前的文献一致，退休年龄似乎是一个脆弱的时期，邻里条件对老年人健康的影响。社区暴力预防活动应解决弱势群体（如退休年龄的低收入老年人）的安全感问题，以减少未来行动不便的风险。
Background: We investigated whether lack of perceived neighborhood safety due to crime, or living in high crime neighborhoods was associated with incident mobility disability in elderly populations. We hypothesized that low-income elders and elders at retirement age (65-74) would be at greatest risk of mobility disability onset in the face of perceived or measured crime-related safety hazards.Methods: We conducted the study in the New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE), a longitudinal cohort study of community-dwelling elders aged 65 and older who were residents of New Haven, Connecticut in 1982. Elders were interviewed beginning in 1982 to assess mobility (ability to climb stairs and walk a half mile), perceptions of their neighborhood safety due to crime, annual household income, lifestyle characteristics (smoking, alcohol use, physical activity), and the presence of chronic co-morbid conditions. Additionally, we collected baseline data on neighborhood crime events from the New Haven Register newspaper in 1982 to measure local area crime rates at the census tract level.Results: At baseline in 1982, 1,884 elders were without mobility disability. After 8 years of follow-up, perceiving safety hazards was associated with increased risk of mobility disability among elders at retirement age whose incomes were below the federal poverty line (HR 1.56, 95% CI 1.02 - 2.37). No effect of perceived safety hazards was found among elders at retirement age whose incomes were above the poverty line. No effect of living in neighborhoods with high crime rates (measured by newspaper reports) was found in any sub-group.Conclusion: Perceiving a safety hazard due to neighborhood crime was associated with increased risk of incident mobility disability among impoverished elders near retirement age. Consistent with prior literature, retirement age appears to be a vulnerable period with respect to the effect of neighborhood conditions on elder health. Community violence prevention activities should address perceived safety among vulnerable populations, such as low-income elders at retirement age, to reduce future risks of mobility disability.