Individual and Neighborhood Socioeconomic Status and the Association between Air Pollution and Cardiovascular Disease.
Individual and Neighborhood Socioeconomic Status and the Association between Air Pollution and Cardiovascular Disease.
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DOI：
10.1289/ehp199
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发表时间：
2016-12
影响因子：
10.4
通讯作者：
Kaufman JD
中科院分区：
文献类型：
--
作者：
Chi GC;Hajat A;Bird CE;Cullen MR;Griffin BA;Miller KA;Shih RA;Stefanick ML;Vedal S;Whitsel EA;Kaufman JD
长期接触细颗粒物 (PM2.5) 与心血管疾病有关，而弱势地位可能会增加对空气污染相关健康影响的易感性。此外，有人担心这种关联可能部分是由社会经济地位（SES）的混杂解释的。我们研究了个人和社区层面的 SES (NSES) 在 PM2.5 暴露与心血管疾病之间的关联中所扮演的角色。研究人群包括来自妇女健康倡议观察研究的 51,754 名绝经后妇女。使用精细区域通用克里金模型预测了参与者住宅的 PM2.5 浓度。我们评估了多个 SES 领域（包括教育、职业和收入/财富）的个人层面 SES 和 NSES（人口普查区层面），并通过 NSES 分数评估了 SES 的几个重要维度。 Cox 比例风险回归根据 SES 因素和其他协变量进行调整，以确定首次心血管事件的风险。 PM2.5 暴露量增加 5 μg/m3 时，心血管事件风险增加 13% [风险比 (HR) 1.13； 95% 置信区间 (CI)：1.02，1.26]。对 SES 因素的调整并未对风险估计产生有意义的影响。生活在低社会经济地位社区的参与者中观察到较高的风险估计。 NSES 评分最不利和最不利四分位数的 HR 分别为 1.39 (95% CI: 1.21, 1.61) 和 0.90 (95% CI: 0.72, 1.07)。 NSES 较低的女性可能更容易受到空气污染相关健康影响。空气污染与心血管疾病之间的关联并不能通过个人层面的 SES 或 NSES 的混杂来解释。 Chi GC、Hajat A、Bird CE、Cullen MR、Griffin BA、Miller KA、Shih RA、Stefanick ML、Vedal S、Whitsel EA、Kaufman JD。 2016。个人和社区的社会经济地位以及空气污染与心血管疾病之间的关联。环境健康视角 124：1840–1847； http://dx.doi.org/10.1289/EHP199
Long-term fine particulate matter (PM2.5) exposure is linked with cardiovascular disease, and disadvantaged status may increase susceptibility to air pollution-related health effects. In addition, there are concerns that this association may be partially explained by confounding by socioeconomic status (SES). We examined the roles that individual- and neighborhood-level SES (NSES) play in the association between PM2.5 exposure and cardiovascular disease. The study population comprised 51,754 postmenopausal women from the Women’s Health Initiative Observational Study. PM2.5 concentrations were predicted at participant residences using fine-scale regionalized universal kriging models. We assessed individual-level SES and NSES (Census-tract level) across several SES domains including education, occupation, and income/wealth, as well as through an NSES score, which captures several important dimensions of SES. Cox proportional-hazards regression adjusted for SES factors and other covariates to determine the risk of a first cardiovascular event. A 5 μg/m3 higher exposure to PM2.5 was associated with a 13% increased risk of cardiovascular event [hazard ratio (HR) 1.13; 95% confidence interval (CI): 1.02, 1.26]. Adjustment for SES factors did not meaningfully affect the risk estimate. Higher risk estimates were observed among participants living in low-SES neighborhoods. The most and least disadvantaged quartiles of the NSES score had HRs of 1.39 (95% CI: 1.21, 1.61) and 0.90 (95% CI: 0.72, 1.07), respectively. Women with lower NSES may be more susceptible to air pollution-related health effects. The association between air pollution and cardiovascular disease was not explained by confounding from individual-level SES or NSES. Chi GC, Hajat A, Bird CE, Cullen MR, Griffin BA, Miller KA, Shih RA, Stefanick ML, Vedal S, Whitsel EA, Kaufman JD. 2016. Individual and neighborhood socioeconomic status and the association between air pollution and cardiovascular disease. Environ Health Perspect 124:1840–1847; http://dx.doi.org/10.1289/EHP199