Parent perceptions of neighborhood stressors are associated with general health and child respiratory health among low-income, urban families.
Parent perceptions of neighborhood stressors are associated with general health and child respiratory health among low-income, urban families.
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DOI：
10.3109/02770901003605324
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发表时间：
2010-04
期刊：
影响因子：
--
通讯作者：
Yeatts KB
中科院分区：
文献类型：
--
作者：
Quinn K;Kaufman JS;Siddiqi A;Yeatts KB
这项横断面研究探讨了父母对低收入芝加哥家庭的社区和一般和呼吸系统健康的看法。哮喘不成比例地影响非白人、城市和低社会经济地位（SES）人群，但芝加哥的负担和全国性的流行病，并没有很好地解释已知的危险因素。城市居民经历急性和慢性压力源，产生心理困扰，并假设通过生物和行为途径影响健康。确定与较低的社会经济地位和少数群体地位相关的因素-例如压力-对于理解哮喘的社会模式很重要。我们使用了来自319名5-13岁哮喘/呼吸问题儿童父母的调查数据和主成分分析，以创建代表父母对社区两个方面的看法的暴露变量：集体效能（“CE”）和身体/社会秩序（“秩序”）。调整后的二项回归模型估计了8个二元结局的风险差异（RD）和95%置信区间（CI）。幅度一般与预期一致，即，低对比度与高对比度（最有利）曝光组的RD（RD低对比度与高对比度）大于中对比度与高对比度（RD中对比度与高对比度）。“父母一般健康状况”与“CE”[RDlow v. high=20.8（95% CI：7.8，33.9）]和“order”[RDmid v. high=11.4（95% CI：2.1，20.7）]密切相关，而“子女一般健康状况”几乎没有相关性。在呼吸结局中，只有“夜间醒来”与“CE”[RDlow v. high=16.7（95%CI：2.8，30.6）]和“order”[RDlow v. high=22.2（95%CI：8.6，35.8）]密切相关。“运动不耐受”[RDlow v. high=15.8（95% CI：2.1，29.5）]和“可控性”[RDmid v. high=12.0（95% CI：1.8，22.3）]与“医嘱”中度相关，但与“CE”无关，而“缺课”、”急救药物使用”和“计划外访视”与这两种暴露几乎无相关性。更多的负面看法往往与不良后果的风险更高有关，增加了社会环境有助于健康的证据，并支持对弱势群体中压力健康影响的研究。干预措施不仅必须解决传统的“环境”因素，而且必须解决个人对压力的反应，并试图减轻压力源的影响，同时寻求从结构上解决保健不平等问题。
This cross-sectional study examines parents’ perceptions of their neighborhoods and general and respiratory health among low-income Chicago families. Asthma disproportionately affects non-white, urban, and low socioeconomic status (SES) populations, but Chicago’s burden, and the national epidemic, are not well-explained by known risk factors. Urban dwellers experience acute and chronic stressors that produce psychological distress and are hypothesized to impact health through biological and behavioral pathways. Identifying factors that covary with lower SES and minority-group status -- e.g. stress -- is important for understanding asthma’s social patterning. We used survey data from 319 parents of children 5–13 years with asthma/respiratory problems and principal components analysis to create exposure variables representing parents’ perceptions of two aspects of neighborhoods: collective efficacy (“CE”) and physical/social order (“order”). Adjusted binomial regression models estimated risk differences (RD) and 95% confidence intervals (CI) for eight binary outcomes. Magnitude was generally as expected, i.e., RD for low versus high (most favorable) exposure groups (RDlow v. high) was larger than for the middle vs. high contrast (RDmid v. high). “Parent general health” was strongly associated with “CE” [RDlow v. high=20.8 (95% CI: 7.8, 33.9)] and “order” [RDmid v. high=11.4 (95% CI: 2.1, 20.7)] unlike “child general health” which had nearly null associations. Among respiratory outcomes, only “waking at night” was strongly associated with “CE” [RDlow v. high=16.7 (95% CI: 2.8, 30.6)] and “order” [RDlow v. high=22.2 (95% CI: 8.6, 35.8)]. “Exercise intolerance” [RDlow v. high=15.8 (95% CI: 2.1, 29.5)] and “controllability” [RDmid v. high=12.0 (95% CI: 1.8, 22.3)] were moderately associated with “order” but not with “CE,” while “school absences,” “rescue medication use,” and “unplanned visits” had nearly null associations with both exposures. More negative perceptions tended to be associated with higher risk of undesirable outcomes, adding to evidence that the social environment contributes to health and supporting research on stress’ health impact among disadvantaged populations. Interventions must address not only traditional “environmental” factors but individuals’ reactions to stress and attempt to mitigate effects of stressors while structural solutions to health inequities are sought.
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影响因子：
10.4
作者：
Gee, Gilbert C;Payne-Sturges, Devon C
通讯作者：
Payne-Sturges, Devon C
影响因子：
5
作者：
KESSLER, RC
通讯作者：
KESSLER, RC
影响因子：
3
作者：
Lara, M;Sherbourne, C;Brook, RH
通讯作者：
Brook, RH
影响因子：
3.1
作者：
Booker, CL;Gallaher, P;Johnson, CA
通讯作者：
Johnson, CA
影响因子：
10
作者：
Archea, C.;Yen, I. H.;Blanc, P. D.
通讯作者：
Blanc, P. D.