Health inequalities in Germany: do regional-level variables explain differentials in cardiovascular risk?
Health inequalities in Germany: do regional-level variables explain differentials in cardiovascular risk?
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DOI：
10.1186/1471-2458-7-132
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发表时间：
2007-07-01
影响因子：
4.5
通讯作者：
Razum O
中科院分区：
文献类型：
--
作者：
Breckenkamp J;Mielck A;Razum O
社会经济地位不仅是死亡率的预测因子，而且也是心血管风险和发病率的预测因子。在社会不平等和健康领域正在进行的辩论集中在两个问题上：1）个人健康状况与个人收入以及总体收入不平等（e）相关。G.区域一级？2)如果存在这种关联，它是通过心理社会途径（如压力）还是通过“新物质主义”途径（如对社会基础设施的系统性投资不足）发挥作用？在德国，我们第一次在这里调查心血管健康状况和收入不平等之间的关联，在地区层面，控制个人的社会经济地位。个体水平解释变量（年龄、社会经济状况）和结果数据（体重指数，血压，胆固醇水平）以及区域水平变量（相对贫困比例）取自德国心血管预防研究的基线调查，这是一项横断面、基于社区的多中心干预研究，包括六个社会经济多样化的干预地区，每一次都有大约1800名年龄在25-69岁之间的参与者。多层次模型被用来检查个人和区域水平变量的影响。对于所分析的所有风险因素，与个体效应相比，区域效应较小。总方差的大部分是在个体水平上解释的。在区域一级，仅对男性舒张压和男女胆固醇有统计学显著影响。我们的分析并不支持这样的假设，即在德国，心血管疾病的危险因素在很大程度上与地区层面的收入不平等有关。
Socioeconomic status is a predictor not only of mortality, but also of cardiovascular risk and morbidity. An ongoing debate in the field of social inequalities and health focuses on two questions: 1) Is individual health status associated with individual income as well as with income inequality at the aggregate (e. g. regional) level? 2) If there is such an association, does it operate via a psychosocial pathway (e.g. stress) or via a "neo-materialistic" pathway (e.g. systematic under-investment in societal infrastructures)? For the first time in Germany, we here investigate the association between cardiovascular health status and income inequality at the area level, controlling for individual socio-economic status. Individual-level explanatory variables (age, socio-economic status) and outcome data (body mass index, blood pressure, cholesterol level) as well as the regional-level variable (proportion of relative poverty) were taken from the baseline survey of the German Cardiovascular Prevention Study, a cross-sectional, community-based, multi-center intervention study, comprising six socio-economically diverse intervention regions, each with about 1800 participants aged 25–69 years. Multilevel modeling was used to examine the effects of individual and regional level variables. Regional effects are small compared to individual effects for all risk factors analyzed. Most of the total variance is explained at the individual level. Only for diastolic blood pressure in men and for cholesterol in both men and women is a statistically significant effect visible at the regional level. Our analysis does not support the assumption that in Germany cardiovascular risk factors were to a large extent associated with income inequality at regional level.
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影响因子：
9.1
作者：
BAXTER, J
通讯作者：
BAXTER, J
影响因子：
105.7
作者：
Marmot, M;Wilkinson, RG
通讯作者：
Wilkinson, RG
影响因子：
7.7
作者：
Borrell, LN;Roux, AVD;Clark, BL
通讯作者：
Clark, BL
影响因子：
7.7
作者：
Martikainen, P;Mäkelä, P;Valkonen, T
通讯作者：
Valkonen, T
影响因子：
6.3
作者：
Osler, M;Andersen, AMN;Holstein, BE
通讯作者：
Holstein, BE