Impact of neighborhood resources on cardiovascular disease: a nationwide six-year follow-up.
Impact of neighborhood resources on cardiovascular disease: a nationwide six-year follow-up.
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DOI：
10.1186/s12889-016-3293-5
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发表时间：
2016-07-26
影响因子：
4.5
通讯作者：
Sundquist K
中科院分区：
文献类型：
--
作者：
Calling S;Li X;Kawakami N;Hamano T;Sundquist K
生活在社会贫困的社区与生活方式风险因素有关，例如，吸烟、缺乏运动和不健康饮食，以及心血管疾病风险增加，即，冠心病和中风。其目的是研究心血管疾病的几率是否随社区潜在健康损害和健康促进资源的可用性而变化。在全国范围内对年龄在35-80岁之间的2040826名男性和2153426名女性进行了为期6年的首次住院冠心病或中风随访。社区对健康损害资源的可用性（即，快餐店和酒吧/酒馆）和健康促进资源（即，保健设施和体育活动设施），确定了使用地理信息系统（GIS）。我们发现冠心病和中风的比值比（OR）都有小幅或适度增加，这与损害健康和促进健康的资源的可用性有关。例如，在女性中，与快餐店可用性相关的中风的未校正OR（95%置信区间）为1.18（1.15-1.21）。在男性中观察到类似的模式，OR = 1.08（1.05-1.10）。然而，调整后的邻里水平的剥夺和个人水平的年龄和收入的协会变得较弱或消失。这项为期六年的随访研究表明，社区提供的潜在健康损害以及健康促进资源可能会对冠心病和中风的风险做出微小贡献。然而，大多数这些协会减弱或消失后，调整邻里水平的剥夺和个人水平的年龄和收入。未来的研究需要进一步研究邻里剥夺和心血管疾病之间因果关系的因素。本文的在线版本（doi：10.1186/s12889-016-3293-5）包含补充材料，可供授权用户使用。
Living in a socially deprived neighborhood is associated with lifestyle risk factors, e.g., smoking, physical inactivity and unhealthy diet, as well as an increased risk of cardiovascular disease, i.e., coronary heart disease and stroke. The aim was to study whether the odds of cardiovascular disease vary with the neighbourhood availability of potentially health-damaging and health-promoting resources. A nationwide sample of 2 040 826 men and 2 153 426 women aged 35–80 years were followed for six years for first hospitalization of coronary heart disease or stroke. Neighborhood availability of health-damaging resources (i.e., fast-food restaurants and bars/pubs) and health-promoting resources (i.e., health care facilities and physical activity facilities) were determined by use of geographic information systems (GIS). We found small or modestly increased odds ratios (ORs) for both coronary heart disease and stroke, related to the availability of both health-damaging and health-promoting resources. For example, in women, the unadjusted OR (95 % confidence interval) for stroke in relation to availability of fast-food restaurants was 1.18 (1.15–1.21). Similar patterns were observed in men, with an OR = 1.08 (1.05–1.10). However, the associations became weaker or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. This six year follow-up study shows that neighborhood availability of potentially health-damaging as well as health-promoting resources may make a small contribution to the risk of coronary heart disease and stroke. However, most of these associations were attenuated or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. Future studies are needed to further examine factors in the causal pathway between neighborhood deprivation and cardiovascular disease. The online version of this article (doi:10.1186/s12889-016-3293-5) contains supplementary material, which is available to authorized users.