Neighbourhood socioeconomic status and cardiovascular risk factors: a multilevel analysis of nine cities in the Czech Republic and Germany.
Neighbourhood socioeconomic status and cardiovascular risk factors: a multilevel analysis of nine cities in the Czech Republic and Germany.
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DOI：
10.1186/1471-2458-7-255
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发表时间：
2007-09-21
影响因子：
4.5
通讯作者：
Pikhart H
中科院分区：
文献类型：
--
作者：
Dragano N;Bobak M;Wege N;Peasey A;Verde PE;Kubinova R;Weyers S;Moebus S;Möhlenkamp S;Stang A;Erbel R;Jöckel KH;Siegrist J;Pikhart H
先前的研究表明，贫困社区的心血管死亡率和发病率更高。与行为相关的风险因素分布的不平等是这一趋势的一个可能解释。在我们的研究中，我们研究了心血管危险因素和邻里特征之间的关系。为了评估关联的一致性，设计是跨国家的，使用来自捷克共和国和德国的9个工业城镇的数据。我们结合了两项基于人群的研究的数据集，一项在德国(Heinz Nixdorf Recall(HNR)研究)，另一项在捷克共和国(“东欧的健康、酒精和心理社会因素(HAPIEE)研究”)。HNR的参与率为56%，HAPIEE研究的参与率为55%。这项特殊分析的次样本包括来自德国和捷克九个城镇的11554名男性和女性。从地方行政当局收集了关于326个居民区社会特征的普查资料。我们使用失业率和过度拥挤作为地区层面的社会经济地位(SES)标志。以心血管危险因素肥胖、高血压、吸烟和缺乏运动为反应变量。回归模型得到个人层面的社会地位(教育)和相关协变量的补充。吸烟、肥胖和低体力活动在德国贫困社区更为普遍，即使在控制了包括个人教育在内的个人特征的情况下也是如此。对于高血压来说，关联性很弱。在捷克共和国，人们观察到吸烟和缺乏运动与肥胖和高血压之间的关联，但在对个体水平的协变量进行调整后，没有观察到肥胖和高血压的关联。在这两个国家中，吸烟的关联性最强：在完全调整的模型中，捷克和德国“高失业率”的优势比分别为1.30[95%可信区间1.02-1.66]和1.60[95%可信区间1.29-1.98]。在这项比较研究中，邻里剥夺的影响因国家和危险因素而异；吸烟的影响最强烈和最一致。结果表明，地区水平的SES与健康相关的生活方式相关，这可能是联系社会地位和心血管疾病的一个可能途径。个人教育对社区特征与危险因素之间的关联有相当大的影响。
Previous studies have shown that deprived neighbourhoods have higher cardiovascular mortality and morbidity rates. Inequalities in the distribution of behaviour related risk factors are one possible explanation for this trend. In our study, we examined the association between cardiovascular risk factors and neighbourhood characteristics. To assess the consistency of associations the design is cross-national with data from nine industrial towns from the Czech Republic and Germany. We combined datasets from two population based studies, one in Germany ('Heinz Nixdorf Recall (HNR) Study'), and one in the Czech Republic ('Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) Study'). Participation rates were 56% in the HNR and 55% in the HAPIEE study. The subsample for this particular analysis consists of 11,554 men and women from nine German and Czech towns. Census based information on social characteristics of 326 neighbourhoods were collected from local administrative authorities. We used unemployment rate and overcrowding as area-level markers of socioeconomic status (SES). The cardiovascular risk factors obesity, hypertension, smoking and physical inactivity were used as response variables. Regression models were complemented by individual-level social status (education) and relevant covariates. Smoking, obesity and low physical activity were more common in deprived neighbourhoods in Germany, even when personal characteristics including individual education were controlled for. For hypertension associations were weak. In the Czech Republic associations were observed for smoking and physical inactivity, but not for obesity and hypertension when individual-level covariates were adjusted for. The strongest association was found for smoking in both countries: in the fully adjusted model the odds ratio for 'high unemployment rate' was 1.30 [95% CI 1.02–1.66] in the Czech Republic and 1.60 [95% CI 1.29–1.98] in Germany. In this comparative study, the effects of neighbourhood deprivation varied by country and risk factor; the strongest and most consistent effects were found for smoking. Results indicate that area level SES is associated with health related lifestyles, which might be a possible pathway linking social status and cardiovascular disease. Individual-level education had a considerable influence on the association between neighbourhood characteristics and risk factors.
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影响因子：
13.6
作者：
Chaix, B;Chauvin, P
通讯作者：
Chauvin, P
影响因子：
7.7
作者：
Borrell, LN;Roux, AVD;Clark, BL
通讯作者：
Clark, BL
影响因子：
5.4
作者：
Pikhart, H;Bobak, M;Marmot, M
通讯作者：
Marmot, M
影响因子：
5
作者：
Bosma, H;van de Mheen, HD;Mackenbach, JP
通讯作者：
Mackenbach, JP
影响因子：
5.4
作者：
Bobak, M;Pikhart, H;Marmot, M
通讯作者：
Marmot, M