Explaining variation in health status across space and time: implications for racial and ethnic disparities in self-rated health
Explaining variation in health status across space and time: implications for racial and ethnic disparities in self-rated health
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DOI：
10.1016/s0277-9536(02)00502-6
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发表时间：
2003-10-01
影响因子：
5.4
通讯作者：
Wen, M
中科院分区：
文献类型：
--
作者：
Browning, CR;Cagney, KA;Wen, M
我们使用大都会社区信息中心地铁调查-一个连续的横截面的成年人居住在城市的芝加哥，美国，从1991年到1999年进行-结合1990年的人口普查数据，同时检查在何种程度上自我评价的健康变化在芝加哥社区和跨时间。采用三层次logit模型对自测健康的个体、空间和时间方差进行分解。结果表明，在自我评价的健康在整个社区的变化是解释，在一定程度上，在社区富裕程度的变化。然而，邻里水平的贫困并不是自我评价健康的重要预测因素。此外，与白人相比，社区一级的富裕程度占非洲裔美国人所经历的剩余健康赤字的很大比例（在控制了个人一级的SES之后）。当控制空间自相关性时，以及在主要是非洲裔美国人的社区中考虑时，富裕的影响仍然存在。研究结果还表明，在20世纪90年代的十年中，居住在芝加哥的个人变得更加健康，这种健康状况的改善主要是由于芝加哥居民的教育和收入水平提高。(C)2003爱思唯尔科技有限公司版权所有。
We use the Metropolitan Community Information Center-Metro Survey-a serial cross section of adults residing in the City of Chicago, USA, conducted from 1991 through 1999-in combination with 1990 census data to simultaneously examine the extent to which self-rated health varies across Chicago neighborhoods and across time. Three-level hierarchical logit models are employed to decompose individual, spatial, and temporal variance in self-rated health. Results indicate that variation in self-rated health across neighborhoods is explained, in part, by variation in the level of neighborhood affluence. Neighborhood level poverty, however, is not a significant predictor of self-rated health. Community level affluence, moreover, accounts for a substantial proportion of the residual health deficit experienced by African-Americans when compared with Whites (after controlling for individual level SES). The effects of affluence hold when controlling for spatial autocorrelation and when considered in primarily African-American neighborhoods. Findings also indicate that individuals living in the City of Chicago became significantly healthier over the decade of the 1990s, and that this improvement in health is explained largely by the increasing education and income levels of Chicago residents. (C) 2003 Elsevier Science Ltd. All rights reserved.