Effect of specific aspects of community social environment on the mortality of individuals diagnosed with serious illness.
Effect of specific aspects of community social environment on the mortality of individuals diagnosed with serious illness.
复制标题
社区社会环境的特定方面对诊断为严重疾病的个体死亡率的影响。
DOI：
10.1016/j.socscimed.2005.01.026
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Christakis,NicholasA
中科院分区：
文献类型：
--
作者：
Wen,Ming;Cagney,KathleenA;Christakis,NicholasA
本研究的目的是研究城市社区环境对1993年67岁及以上、居住在芝加哥市、因13种严重疾病之一住院的医疗保险受益人死亡率的前瞻性和情境性影响。正如预期的那样，我们发现有利的社会经济背景有助于降低老年患者的死亡风险，而不是个人人口统计学和健康背景。我们还发现，集体效能是一种促进健康的社会资源，而社区中的犯罪和暴力活动似乎是有害的。与我们的假设不一致的是，社区社会网络密度（通过社会网络的大小和社会互动的频率来衡量）不是保护而是有害的。此外，社区居民的社会支持和公民参与似乎并不影响死亡率。本研究发现的社区社会环境与健康之间的复杂关系可能表明，如果没有经济和卫生保健领域的共同努力，基于社会资本/社会凝聚力模型的社区层面社会干预不太可能取得丰硕成果，至少在对已经患病的老年人健康的影响方面是如此。
The purpose of this study was to examine the prospective and contextual effects of urban community environment on mortality among Medicare beneficiaries who were 67 years old or older in 1993, lived in the city of Chicago, and were hospitalized for one of 13 serious diseases. As expected, we found that advantageous socioeconomic context helps lower mortality risk among elderly patients over and above individual demographic and health background. We also found that collective efficacy was a health-enhancing social resource whereas criminal and violent activities in the community appeared to be deleterious. Inconsistent with our hypotheses, community social network density (measured by the size of social network and frequency of social interaction) was not protective but detrimental. Moreover, social support and the civic involvement of residents in the community do not seem to affect mortality. The complex relationship between community social environment and health found in this study may suggest that community-level social interventions based on social capital/social cohesion models are not likely to achieve fruitful results without concomitant effort in the economic and health care realm, at least in terms of influences on the health of older people once they are already ill.