Association of regional racial/cultural context and socioeconomic status with arthritis in the population:: A multilevel analysis
Association of regional racial/cultural context and socioeconomic status with arthritis in the population:: A multilevel analysis
复制标题
DOI：
10.1002/art.23316
复制
发表时间：
2008-03-15
期刊：
影响因子：
--
通讯作者：
Badley, Elizabeth M.
中科院分区：
文献类型：
--
作者：
Canizares, Mayilee;Power, J. Denise;Badley, Elizabeth M.
Objective.研究个体和地区水平的社会经济地位和种族/文化来源的差异在多大程度上解释了自我报告关节炎患病率的地理差异，并确定地区特征是否改变了与报告关节炎相关的个体特征的影响。分析基于2000-2001年加拿大社区健康调查（>15岁，n = 127，513）。关节炎是自我报告的一种长期疾病，由健康专业人士诊断。采用2水平逻辑回归模型确定报告关节炎的预测因子。个体水平变量包括年龄、性别、收入、教育、移民身份、种族/文化来源、吸烟、体育活动和体重指数。地区层面的变量包括低收入家庭、低教育、失业、新移民、原住民和亚洲人的比例。在个体水平上，年龄、性别、低收入、低教育程度、原住民出身、目前吸烟和超重/肥胖与关节炎报告呈正相关;近期移民和亚裔与关节炎报告呈负相关。在区域一级，低收入家庭和土著人口的百分比与关节炎的报告独立相关。地区收入和种族/文化来源调节个人收入和种族/文化来源的影响;居住在低收入家庭比例较高地区的低收入个体报告关节炎的比例高于居住在收入较高地区的低收入个体。个体和区域因素都被发现有助于关节炎患病率的变化，尽管仍然存在显著的无法解释的变化。需要进一步的研究，以更好地了解这些区域效应的机制，并确定其他因素的影响，其余的变化。
Objective. To examine the extent to which differences in individual- and regional-level socioeconomic status and racial/cultural origin account for geographic variations in the prevalence of self-reported arthritis, and to determine whether regional characteristics modify the effect of individual characteristics associated with reporting arthritis.Methods. Analyses were based on the 2000-2001 Canadian Community Health Survey (>15 years, n = 127,513). Arthritis was self-reported as a long-term condition diagnosed by a health professional. A 2-level logistic regression model was used to identify predictors of reporting arthritis. Individual-level variables included age, sex, income, education, immigration status, racial/cultural origin, smoking, physical activity, and body mass index. Regional-level variables included the proportion of low-income families, low education, unemployment, recent immigrants, Aboriginals, and Asians.Results. At the individual level, age, sex, low income, low education, Aboriginal origin, current smoking, and overweight/obesity were positively associated with reporting arthritis; recent immigration and Asian origin were negatively associated with reporting arthritis. At the regional level, percentages of low-income families and the Aboriginal population were independently associated with reporting arthritis. Regional income and racial/cultural origin moderated the effects of individual income and racial/cultural origin; low-income individuals residing in regions with a higher proportion of low-income families reported arthritis more than low-income individuals living in better-income regions.Conclusion. Both individual and regional factors were found to contribute to variations in the prevalence of arthritis, although significant unexplained variation remained. Further research is required to better understand the mechanisms that underlie these regional effects and to identify other contributing factors to the remaining variation.