Neighborhood Self-Selection: The Role of Pre-Move Health Factors on the Built and Socioeconomic Environment.
Neighborhood Self-Selection: The Role of Pre-Move Health Factors on the Built and Socioeconomic Environment.
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DOI：
10.3390/ijerph121012489
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发表时间：
2015-10-08
影响因子：
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通讯作者：
Subramanian SV
中科院分区：
文献类型：
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作者：
James P;Hart JE;Arcaya MC;Feskanich D;Laden F;Subramanian SV
住宅自我选择偏差是社区和健康研究中的一个问题。这种偏见是由健康行为预测邻里选择的结果。为了量化这种偏差，我们在护士健康研究（1986-2008年，n = 14，159次移动）中检查了移动前健康因素（身体质量指数，步行和总体力活动）与移动后社区因素（县蔓延指数，人口普查区域社会经济地位（SES））之间的关联。与最低四分位数（BMI < 22.5）相比，移动前BMI最高的四分位数（BMI > 28.4）的人搬到了平均蔓延指数低2.57点的县（95%置信区间-3.55，-1.59），表明个人搬到了密度较低的县;然而，没有观察到移动前步行或总体力活动的相关性。搬迁前BMI较高的个人倾向于搬到收入中位数和房屋价值较低以及贫困程度较高的人口普查区。对搬家后邻里环境变化的分析表明，健康的搬家前行为与搬到更差的社会经济环境有关。这种类型的自我选择会使结果向下偏移，低估了SES和身体活动之间的真实关系。一般来说，搬迁前的健康因素和邻里措施之间的关联程度很小，并表示，住宅自我选择是不是在这个人群中的分析偏差的主要来源。
Residential self-selection bias is a concern in studies of neighborhoods and health. This bias results from health behaviors predicting neighborhood choice. To quantify this bias, we examined associations between pre-move health factors (body mass index, walking, and total physical activity) and post-move neighborhood factors (County Sprawl Index, Census tract socioeconomic status (SES)) in the Nurses’ Health Study (n = 14,159 moves from 1986–2008). Individuals in the highest quartile of pre-move BMI (BMI > 28.4) compared to the lowest quartile (BMI < 22.5) moved to counties that averaged 2.57 points lower on the sprawl index (95% confidence interval −3.55, −1.59) indicating that individuals moved to less dense counties; however, no associations were observed for pre-move walking nor total physical activity. Individuals with higher pre-move BMI tended to move to Census tracts with lower median income and home values and higher levels of poverty. Analyses examining the change in neighborhood environments after a move demonstrated that healthy pre-move behaviors were associated with moves to worse socioeconomic environments. This type of self-selection would bias results downward, underestimating the true relationship between SES and physical activity. Generally, the magnitudes of associations between pre-move health factors and neighborhood measures were small and indicated that residential self-selection was not a major source of bias in analyses in this population.