Der Einfluß kontextueller Merkmale auf die Entstehung gesundheitlicher Ungleichheit: Theoriebildung und Methodenentwicklung

背景特征对健康不平等出现的影响：理论构建和方法开发

基本信息

批准号：
161104643
负责人：
Professor Dr. Oliver Razum
金额：
--
依托单位：
Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2009
资助国家：
德国
起止时间：
2008-12-31 至 2016-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/161104643?language=en
关键词：
Der Einflu kontextueller Merkmale auf

项目摘要

The relationship between social inequalities and health is well documented. Until now, social factors at the individual level have predominantly been considered. In our previous DFG project we could demonstrate that factors of the small-scale environment or context of persons play a role in the production of health inequalities, and include them in a theoretical model. Due to data availability, administratively defined spatial levels had to be used; the question what geographical levels are the most relevant for understanding the association between contextual factors and health still remains to be answered. A definition of such small areas (neighbourhoods) from the point of view of an individual might be more appropriate to understand how contextual factors influence individual health and contribute to the development of health inequalities. In the present project, such a notion of neighbourhood is investigated. We will study two aspects: the neighbourhood s mediating role between place and health of an individual (subject matter aspect) and its quantitative characterisation (methodological aspect).The aim is to assess, within five distinct German and European urban areas, how the neighbourhoods are characterised and which among a range of individual and contextual variables affect those characteristics. Five different cohorts providing measures of geo-location and of individuals health are available. The covariates of interest will include demographic data, individual and contextual measures of socio-economic status and subjective measures of perception of the environment. Also a comparison of the results obtained will be performed between the German and European urban areas in order to assess which parameters could further refine our general theoretical model explaining the mediation between place and health. In terms of methodology, such a neighbourhood will be defined, on average over all individuals in a single urban area, by a disk containing neighbours whose health is correlated to the health of the individual at its centre. The neighbourhood is characterised by its range and the strength of the correlation. We will model the correlation structure using semi-variograms. The effect of covariates will be assessed by modelling the correlation of residuals. Issues around sample size and distribution of the data over the area (cluster or uniform) will be investigated through simulations in order to advise on the optimal size and sample form to obtain estimates of strength and range. This project will deepen the understanding of the mechanisms which mediate the relationship between place and health. A strong correlation between health outcomes in the neighbourhood indicates context-dependent health inequities. Understanding the factors at work will inform Public Health strategies to tackle those inequities.

社会不平等与健康之间的关系已得到充分记录。到目前为止，主要考虑了个人层面的社会因素。在我们以前的DFG项目中，我们可以证明小规模环境或人环境的因素在健康不平等的生产中起作用，并将其包括在理论模型中。由于数据的可用性，必须使用行政定义的空间级别；问题与理解背景因素与健康之间的关联最相关的地理层面仍然有待回答。从个人的角度来看，此类小领域（社区）的定义可能更合适地了解情境因素如何影响个人健康并有助于健康不平等的发展。在本项目中，研究了这样的社区概念。我们将研究两个方面：个人（主题方面）及其定量表征（方法论方面）之间的邻里中介作用。目的是在五个不同的德国和欧洲城市地区，社区的表征以及各个个体和背景变量影响这些特征的范围。提供了五个不同的人群，提供地理位置和个人健康的措施。感兴趣的协变量将包括人口统计数据，社会经济地位的个人和上下文度量，以及对环境感知的主观度量。还将在德国和欧洲城市地区之间对获得的结果进行比较，以评估哪些参数可以进一步完善我们的一般理论模型，以解释地点与健康之间的调解。在方法论方面，将在一个城市地区的所有个人中平均定义了一个磁盘，该磁盘与邻居的健康相关。该社区的特征是其范围和相关强度。我们将使用半变量图对相关结构进行建模。协变量的效果将通过对残差的相关性进行建模来评估。将通过模拟研究样本量和数据分布（群集或统一）的问题，以便就最佳大小和样本形式进行建议，以获得强度和范围的估计。该项目将加深对介导地点与健康之间关系的机制的理解。邻里健康结果之间的密切相关性表明与上下文有关的健康不平等。了解工作因素将为应对这些不平等的公共卫生策略提供信息。