Quantifying neighbourhood socioeconomic effects in clustering of behaviour-related risk factors: a multilevel analysis.
Quantifying neighbourhood socioeconomic effects in clustering of behaviour-related risk factors: a multilevel analysis.
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DOI：
10.1371/journal.pone.0032937
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Vahtera J
中科院分区：
文献类型：
--
作者：
Halonen JI;Kivimäki M;Pentti J;Kawachi I;Virtanen M;Martikainen P;Subramanian SV;Vahtera J
社区特征在多大程度上解释了健康行为的积累，人们对此知之甚少。我们研究了邻里劣势是否与行为相关风险因素的共同出现有关，以及共同出现的邻里差异中有多少可以用个人和邻里水平的协变量来解释。研究对象包括2004年和2008年的60 694名芬兰公共部门研究参与者。使用关于家庭收入、教育程度和失业率的小范围信息来确定邻里劣势，并使用全球定位系统坐标将其与个人数据联系起来。通过多水平累积Logistic回归，确定了邻里劣势与三种与行为相关的危险因素(吸烟、酗酒和缺乏体力活动)共同出现的相关性，以及个人和邻里水平协变量对共同出现危险因素的邻里差异的解释程度。在调整了年龄、性别、婚姻状况和人口密度后，我们发现在个人社会经济地位的每个水平内，邻里不利因素和危险因素共同出现之间存在剂量-反应关系。健康风险总和的累积优势比介于1.13(95%可信区间：1.03-1.24)和1.75(95%可信区间，1.54-1.98)之间。个人社会经济特征解释了35%，与邻里劣势和人口密度17%的邻里差异共同出现的危险因素。除了个人的社会经济地位之外，与邻里劣势有关的不良健康行为并存。仅使用个人社会经济因素不能反映邻里差异，但还应考虑邻里层面的特点。
The extent to which neighbourhood characteristics explain accumulation of health behaviours is poorly understood. We examined whether neighbourhood disadvantage was associated with co-occurrence of behaviour-related risk factors, and how much of the neighbourhood differences in the co-occurrence can be explained by individual and neighbourhood level covariates. The study population consisted of 60 694 Finnish Public Sector Study participants in 2004 and 2008. Neighbourhood disadvantage was determined using small-area level information on household income, education attainment, and unemployment rate, and linked with individual data using Global Positioning System-coordinates. Associations between neighbourhood disadvantage and co-occurrence of three behaviour-related risk factors (smoking, heavy alcohol use, and physical inactivity), and the extent to which individual and neighbourhood level covariates explain neighbourhood differences in co-occurrence of risk factors were determined with multilevel cumulative logistic regression. After adjusting for age, sex, marital status, and population density we found a dose-response relationship between neighbourhood disadvantage and co-occurrence of risk factors within each level of individual socioeconomic status. The cumulative odds ratios for the sum of health risks comparing the most to the least disadvantaged neighbourhoods ranged between 1.13 (95% confidence interval (CI): 1.03–1.24) and 1.75 (95% CI, 1.54–1.98). Individual socioeconomic characteristics explained 35%, and neighbourhood disadvantage and population density 17% of the neighbourhood differences in the co-occurrence of risk factors. Co-occurrence of poor health behaviours associated with neighbourhood disadvantage over and above individual's own socioeconomic status. Neighbourhood differences cannot be captured using individual socioeconomic factors alone, but neighbourhood level characteristics should also be considered.
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影响因子：
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作者：
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