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1.
STUDY OBJECTIVE: To investigate the relation between neighbourhood socioeconomic and ethnic characteristics with depressive symptoms in a population based sample. DESIGN: Cross sectional data from the CARDIA study, including the Center for Epidemiological Studies depression scale score (CES-D). Neighbourhoods were 1990 US census blocks of 1000 people; six census variables reflecting wealth/income, education, and occupation investigated separately and as a summary score; neighbourhood racial composition (percentage white and black) and individual level income and education were also examined. SETTING: Participants recruited in 1985/86 from community lists in Birmingham, AL; Chicago, IL; Minneapolis MN; from a health plan in Oakland, CA. PARTICIPANTS: 3437 adults aged 28-40 years in 1995/96: 24% white men, 27% white women, 20% black men, 29% black women. MAIN RESULTS: For each race-sex group, CES-D was inversely related to neighbourhood score and individual income and education. Associations of neighbourhood score with CES-D became weak and inconsistent after adjusting for individual level factors; personal income remained strongly and inversely associated with CES-D. Age adjusted mean differences (standard errors) in CES-D between the lowest and highest income categories were 3.41 (0.62) for white men, 4.57 (0.64) for white women, 5.80 (0.87) for black men, and 5.74 (0.83) for black women. For both black and white participants, CES-D was associated negatively with percentage of white people and positively with percentage of black people in their census block, before, but not after, adjustment for individual and neighbourhood socioeconomic variables. CONCLUSIONS: Neither neighbourhood socioeconomic characteristics nor ethnic density were consistently related to depressive symptoms once individual socioeconomic characteristics were taken into account.  相似文献   

2.
Past research has observed inverse associations between neighborhood and personal level measures of socioeconomic status and body mass index (BMI), but has not assessed how personal and neighborhood-level measures might interact together to predict BMI. Using a sample of 13,102 adult residents of New York City who participated in a health survey, cross-sectional multi-level analyses assessed whether personal income, education and Zip code-level poverty rates were associated with BMI. Demographic, income, education and objectively measured height and weight data were collected in the survey and poverty rates and the proportion of Black and Hispanic residents in the subject's Zip code were retrieved from the 2000 Census. Zip code-level population density and land use mix, indices of neighborhood walk-ability which are often higher in lower income neighborhoods and are associated with lower BMI, were also measured. After controlling for individual and Zip code-level demographic characteristics, increasing income was associated with lower BMI in women but not in men, and college and graduate level education was associated with lower BMI in both men and women. After control for income and individual and Zip code-level demographic characteristics, higher Zip code poverty rate was unassociated with BMI. However, as expected, indices of neighborhood walk-ability acted as substantial inverse confounders in the relationship between Zip code poverty rate and BMI. After further adjustment for indices of neighborhood walk-ability, Zip code poverty rate became significantly, and positively associated with BMI in women. Among women, the inverse association between income and BMI was significantly stronger in richer compared to poorer Zip codes. In men and women, the association between college and graduate education and lower BMI was significantly stronger in richer versus poorer Zip codes. These analyses suggest that neighborhood socioeconomic context influences how personal socioeconomic status interact in predicting boby size.  相似文献   

3.
This study examined the contributions of both individual socioeconomic status (SES) and community disadvantage in explaining the higher body mass index (BMI) of black adults in the US. Data from a national survey of adults (1986 American's Changing Lives Study) were combined with tract-level community data from the 1980 census. Results of multilevel regression analyses showed that black women had an age-adjusted BMI score three points higher than non-black women. Individual SES (income, education, assets) was negatively associated with BMI in women, but it only reduced the association between race and BMI from 2.99 to 2.50. Adding community socioeconomic disadvantage index further reduced the race coefficient slightly from 2.50 to 2.21. Nevertheless, living in communities with higher socioeconomic disadvantage was associated with higher BMI net of age, race, individual SES, smoking, physical activity, stress, and social support. Community income inequality (Gini) had an independent positive association with BMI, but did not substantially reduce racial differences among women. Community percent black was not associated with BMI. Results for men demonstrated no statistically significant racial differences in BMI, and no association between BMI and either individual SES or community disadvantage. Although individual SES and community socioeconomic disadvantage each partly explained the higher average BMI among black women, clear racial disparities persisted. Moreover, race, individual SES, community socioeconomic disadvantage, and individual health behaviors were each independent predictors of BMI among women. Unexplained within- and between-community variance in BMI remained among both women and men, with most unexplained variation due to within-community variance. Because our evidence for women suggests that the determinants of obesity are multiple and multilevel, attempts to address this growing social problem will similarly require a multi-faceted and multilevel approach.  相似文献   

4.
Many studies document racial variation, gender differences, and socioeconomic status (SES) patterning in cardiovascular disease (CVD) risk factors but few studies have investigated heterogeneity in SES differences by race/ethnicity or gender. Using data from the Multi-Ethnic Study of Atherosclerosis (N=6,814) and stratified regression models, we investigated race/ethnic differences in the SES patterning of diabetes, hypertension, smoking, and body mass index (BMI). Inverse socioeconomic gradients in hypertension, diabetes, smoking, and BMI were observed in White and Black women but associations were weaker or absent in Hispanic and Chinese women (except in the case of diabetes for Hispanic women). Even greater heterogeneity in social patterning of risk factors was observed in men. In White men all four risk factors were inversely associated with socioeconomic position, although often associations were only present or were stronger for education than for income. The inverse socioeconomic patterning was much less consistent in men of other races/ethnic groups, and higher SES was associated with higher BMI in non-White men. These findings have implications for understanding the causes of social patterning, for the analysis of SES adjusted race/ethnic differences, and for the targeting of interventions.  相似文献   

5.
BACKGROUND: The incidence of myocardial infarction (MI) varies among socioeconomic groups, and geographic differences in incidence rates are observed within most urban regions. Whether spatial social differentiation gives rise to social contexts detrimental to health is still an open question. In this study, we evaluate 2 aspects of the neighborhood context as contributory factors in MI: level of economic resources and degree of socioeconomic homogeneity. We adopt a multilevel approach to analyze potential mechanisms, which involve individual social characteristics. METHODS: We analyzed data from the SHEEP study, a population-based case-control study of first events of acute MI in Stockholm County in 1992-1994. Data on socioeconomic characteristics in neighborhoods came from total population registers of income and social circumstances. RESULTS: The level of neighborhood socioeconomic resources had a contextual effect on the relative risk of MI after adjustment for individual social characteristics. The incidence rate ratio (IRR) in low-income, compared with high-income, neighborhoods was 1.88 for women and 1.52 for men. Although the degree of socioeconomic homogeneity in neighborhoods has less impact on MI, the IRR for men in homogenous low-income areas compared with men living in heterogeneous high-income areas was 2.65. For men, the combined exposure to low-personal disposable income and low-income level in the neighborhood seemed to have an additive effect but for women, a synergistic (supra-additive) effect was found. CONCLUSION: The socioeconomic context of neighborhoods has an effect on cardiovascular outcomes.  相似文献   

6.
PURPOSE: Socioeconomic position (SEP) has been shown to be related to obesity and weight gain, especially among women. It is unclear how different measures of socioeconomic position may impact weight gain over long periods of time, and whether the effect of different measures vary by gender and age group. We examined the effect of childhood socioeconomic position, education, occupation, and log household income on a measure of weight gain using individual growth mixed regression models and Alameda County Study data collected over thirty four years(1965-1999). METHODS: Analyses were performed in four groups stratified by gender and age at baseline: women, 17-30 years (n = 945) and 31-40 years (n = 712); men, 17-30 years (n = 766) and 31-40 years (n = 608). RESULTS: Low childhood SEP was associated with increased weight gain among women 17-30 (0.13 kg/year, p < 0.001). Low educational status was associated with increased weight gain among women 17-30 (0.14 kg/year, p = 0.030), 31-40 (0.14 kg/year, p = 0.014), and men 17-30 (0.20 kg/year, p = 0.001). CONCLUSION: Log household income was inversely associated with weight gain among men 31-40 (-0.10 kg/yr, p = 0.16). Long-term weight gain in adulthood is associated with childhood SEP and education in women and education and income in men.  相似文献   

7.
Secular trends in the relationship of body mass index (BMI) and skinfold thickness to educational and income levels were examined for white and black men aged 18-34 y over the period 1960-80 with data from three successive national surveys: NHES Cycle I, NHANES I, and NHANES II. Statistical models were fitted to assess the variability in mean BMI over time within levels of education or income. There were few secular changes in mean BMI. In both white and black men a secular change from a slight positive association between mean BMI and education to a negative association was characterized chiefly by an increase in mean BMI at the lowest educational level. A slight positive association between income level and mean BMI persisted almost unchanged over this period. Mean BMI was similar for black and white men. These findings are compared and contrasted with those from a similar study for young women.  相似文献   

8.
OBJECTIVES: This study sought to examine relationships between neighborhood socioeconomic characteristics and birthweight, accounting for individual socioeconomic characteristics, among 5 ethnic groups. METHODS: Birth records were linked to census block-group data for 22 304 women delivering infants at 18 California hospitals during 1994-1995. Information on income and additional factors was obtained from a surveyed subset of 8457 women. Neighborhood levels of poverty, unemployment, and education were examined. RESULTS: After adjustment for mothers' individual socioeconomic characteristics and other risk factors, less-favorable neighborhood socioeconomic characteristics were associated with lower birthweight among Blacks and Asians. No consistent relationship between neighborhood socioeconomic characteristics and birthweight was found among Whites, US-born Latinas, or foreign-born Latinas overall, but birthweight increased with less-favorable neighborhood socioeconomic characteristics among foreign-born Latinas in high-poverty or high-unemployment neighborhoods. These findings were not explained by measured behavioral or cultural factors. CONCLUSIONS: In addition to individual socioeconomic characteristics, living in neighborhoods that are less socioeconomically advantaged may differentially influence birthweight, depending on women's ethnicity and nativity.  相似文献   

9.
The association between socioeconomic position and health is generally believed to be weaker among women than men. However, gender differences in the relation between socioeconomic position and coronary heart disease have not been evaluated in a representative sample of the US population. The authors examined this association in the First National Health and Nutrition Examination Survey (1971-1993), a longitudinal, representative study of the US population (n = 6,913). Information on educational attainment, household income, and covariates was derived from the baseline interview, and that on incident coronary heart disease was obtained from hospital records/death certificates over 22 years of follow-up. Cox's proportional hazards models showed that education and income were inversely associated with incident coronary heart disease in age-only and multivariate models. Risk associated with education varied by gender (p = 0.01), with less than high school education associated with stronger risk of coronary heart disease in women (relative risk = 2.15, 95% confidence interval: 1.46, 3.17) than in men (relative risk = 1.58, 95% confidence interval: 1.18, 2.12) in age-adjusted models. Low education was associated with greater social and psychological risks for women than men; however, metabolic risks largely explained gender differences in the educational gradient in coronary heart disease.  相似文献   

10.
AIMS: Little is known about changes in lifestyle and socioeconomic characteristics among physical activity subgroups over time. This study aimed at assessing whether the lifestyle and the socioeconomic profile of people with either low total physical activity (TPA) or high TPA changed during 1972-97. METHODS: Six independent cross-sectional surveys were carried out among a middle-aged population at five-year intervals in Eastern Finland, 1972-97. The participation rates varied from 71% to 95% (n = 33,712). Physical activity during leisure time (LTPA) and occupational physical activity (OPA) were determined by a self-administered questionnaire. TPA was calculated by combining LTPA and OPA. RESULTS: Men with low TPA were older, smoked more, and had a higher BMI than men with high TPA. The increase in BMI was almost fourfold in sedentary men (trend 0.4%/5 years, p = 0.023 for trend) than in highly active men (trend 0.1%/5 years, p = 0.044 for trend). Education no longer accounted for the socioeconomic difference after 1977. Sedentary women had a higher BMI and smoking prevalence than those with high TPA. The difference in age, education, and marital status disappeared between those two groups after 1977. CONCLUSIONS: The lifestyle and the socioeconomic profiles of people with both low TPA and high TPA have changed during 1972-97.  相似文献   

11.
PURPOSE: To elucidate the influence of individual socioeconomic status on smoking in Japanese adults. METHODS: Using a nationally representative sample (20,206 men and 21,093 women aged 18 to 54 years), the relation between smoking and socioeconomic characteristics was analyzed by sex and age group (18 to 24, 25 to 39, and over 40 years). RESULTS: The smoking prevalence was 57.0% for men and 16.6% for women. Living in an urban area was a negative factor for smoking in men, while a positive factor in women. Being married was positively associated with smoking in the younger population, but negatively associated in the older population. A relation between lower income and smoking was found in all groups, except in men aged 18 to 24 years. The income-related difference was most pronounced in the population aged 25 to 39 years: OR of smoking for the highest income quintile compared with the lowest was 0.60 (95% CI, 0.51-0.71) for men and 0.29 (95% CI, 0.23-0.35) for women. CONCLUSIONS: Socioeconomic status, especially income, substantially predicted smoking in the Japanese population, while the impact differed according to sex and age groups. Effective anti-smoking strategies require consideration of the gender and age differences in the socioeconomic pattern of smoking.  相似文献   

12.
This study focuses on associations between schooling, income, and body mass index (BMI). The analyses are based on data from 3,963 public university employees in Rio de Janeiro, Brazil, participating in phase 1 of a longitudinal study (the Pró-Saúde Study). ANOVA, Wald test, and generalized linear models were used to analyze differences between subgroups. Obesity prevalence was inversely associated with schooling, especially among women (p < 0.001). In regression analyses, schooling and per capita income were not associated with BMI among men. In women, schooling but not income was significantly and inversely associated with BMI (p < 0.001). Thus, low schooling plays an important role in the social determination of obesity, especially among women.  相似文献   

13.
In this study, the authors examined whether neighborhood socioeconomic environment predicted incident coronary heart disease after adjustment for individual-level characteristics. A random sample of the Swedish population (25,319 women and men aged 35-74 years) was interviewed between 1986 and 1993 and was followed through December 1997 for incident coronary heart disease (1,189 events). Neighborhood socioeconomic environment was defined by small-area market statistics (6,145 neighborhoods) and measured by two indicators: neighborhood education (proportion of people with less than 10 years of education in the neighborhood) and neighborhood income (proportion of people with incomes in the lowest national income quartile). Separate multilevel Cox proportional hazards models showed that low neighborhood education and low neighborhood income each predicted incident coronary heart disease after adjustment for age, sex, and individual-level education and income (hazard ratios were 1.25 and 1.23, respectively). The authors conclude that neighborhood socioeconomic environment predicts incident coronary heart disease, having a significant effect on coronary heart disease risk beyond the individual effect.  相似文献   

14.
OBJECTIVE: To examine the association between relative body weight and health status and the potential modifying effects of socioeconomic position and working conditions on this association. RESEARCH METHODS AND PROCEDURES: The data were derived from three identical cross-sectional surveys conducted in 2000, 2001, and 2002. Respondents to postal surveys were middle-aged employees of the City of Helsinki (7148 women and 1799 men, response rate 67%). BMI was based on self-reported weight and height. Health status was measured by the Short-Form 36 subscales and component summaries. RESULTS: Body weight was inversely associated with physical health, but in mental health, differences between BMI categories were small and inconsistent. In women, physical health deteriorated monotonically with increasing BMI, whereas in men, poor physical health was found among the obese only. Socioeconomic position did not modify the association between BMI and health. In women, the association between body weight and physical health became stronger with decreasing job control and increasing physical work load, whereas in men, a similar modifying effect was found for high job demands. DISCUSSION: Body weight was associated with physical health only. Lower levels of relative weight in women than in men may be associated with poor physical health. High body weight combined with adverse working conditions may impose a double burden on physical health.  相似文献   

15.
Secular trends in the relationship of body mass index (BMI) and skinfold thickness to educational and income levels were examined for white and black women aged 18-34 y over the period 1960-80 with data from three successive national surveys: NHES Cycle I, NHANES I, and NHANES II. Statistical models were fitted to assess the variability in mean BMI over time within levels of education or income. Mean BMI and skinfold thickness were negatively associated with both education and income. Over the 20-y period mean BMI increased for both white and black women at all levels of income and education. Because the increase in mean BMI was greater at lower educational levels, the differentiation of BMI by educational level increased over time, yielding a stronger negative association. In contrast differentiation of BMI by income category decreased over time. Black-white differences in mean BMI at comparable educational and income levels persisted over this period.  相似文献   

16.
There has been recent interest in determining whether neighborhood characteristics are related to the cardiovascular health of residents. However, there are no data regarding the relationship between neighborhood socioeconomic status (SES) and prevalence of subclinical cardiovascular disease (CVD) in the elderly. We related personal SES (education, income, and occupation type) and neighborhood socioeconomic characteristics (a block-group score summing six variables reflecting neighborhood income and wealth, education, and occupation) to the prevalence of subclinical CVD (asymptomatic peripheral vascular disease or carotid atherosclerosis, electrocardiogram or echocardiogram abnormalities, and/or positive responses to Rose Questionnaire claudication or angina pectoris) among 3545 persons aged 65 and over, without prevalent CVD, in the Cardiovascular Health Study. Sixty percent of participants had at least one indicator of subclinical disease. Compared to those without, those with subclinical disease had significantly lower education, income, and neighborhood scores and were more likely to have blue-collar jobs. After adjustment for age, gender, and race, those in the lowest SES groups had increased prevalence of subclinical disease compared with those in the highest SES groups (OR = 1.50; 95% CI 1.21, 1.86 for income; OR = 1.41; 95% CI 1.18, 1.69 for education; OR = 1.39; 95% CI 1.16, 1.67 for block-group score). Those reporting a blue-collar lifetime occupation had greater prevalence of subclinical disease relative to those reporting a white-collar occupation (OR = 1.29; 95% CI 1.02-1.59). After adjustment for behavioral and biomedical risk factors, all of these associations were reduced. Neighborhood score tended to remain inversely associated with subclinical disease after adjustment for personal socioeconomic indicators but associations were not statistically significant. Personal income and blue-collar occupation remained significantly associated with subclinical disease after simultaneous adjustment for neighborhood score and education. Personal and neighborhood socioeconomic indicators were associated with subclinical disease prevalence in this elderly cohort. These relationships were reduced after controlling for traditional CVD risk factors.  相似文献   

17.
Most studies of socioeconomic status (SES) and chronic disease risk factors have been conducted in high-income countries, and most show inverse social gradients. Few studies examine these patterns in lower- or middle-income countries. Using cross-sectional data from a 2005 national risk factor survey in Argentina (a middle-income country), we investigated the associations of individual- and area-level SES with chronic disease risk factors (body mass index [BMI], hypertension, and diabetes) among residents of Buenos Aires. Associations of risk factors with income and education were estimated after adjusting for age, sex (except in sex-stratified models), and the other socioeconomic indicators. BMI and obesity were inversely associated with education and income for women, but not for men (e.g., mean differences in BMI for lowest versus highest education level were 1.55 kg/m2, 95%CI = 0.72-2.37 in women and 0.17 kg/m2, 95%CI = -0.72-1.06 in men). Low education and income were also associated with increased odds of hypertension diagnosis in all adults (adjusted odds ratio [AOR] = 1.48, 95%CI = 0.99-2.20 and AOR = 1.50, 95%CI = 0.99-2.26 for the lowest compared to the highest education and income categories, respectively). Lower education was strongly associated with increased odds of diabetes diagnosis (AOR = 4.12, 95%CI = 1.85-9.18 and AOR = 2.43, 95%CI = 1.14-5.20 for the lowest and middle education categories compared to highest, respectively). Area-level education also showed an inverse relationship with BMI and obesity; these results did not vary by sex as they did at the individual level. This cross-sectional study of a major urban area provides some insight into the global transition with a trend toward concentrations of risk factors in poorer populations.  相似文献   

18.
STUDY OBJECTIVES: To compare associations of childhood and adult socioeconomic position with cardiovascular risk factors measured in adulthood. To estimate the effects of adult socioeconomic position after adjustment for childhood circumstances. DESIGN: Cross sectional survey, using the relative index of inequality method to compare socioeconomic differences at different life stages. SETTING: The Whitehall II longitudinal study of men and women employed in London offices of the Civil Service at study baseline in 1985-88. PARTICIPANTS: 4774 men and 2206 women born in the period 1930-53 who were administered questions on early socioeconomic circumstances. MAIN RESULTS: Adult occupational position (employment grade) was inversely associated (high status-low risk) with current smoking and leisure time physical inactivity, with waist/height, and with metabolic risk factors HDL cholesterol, triglycerides, post-load glucose and fibrinogen. Associations of these variables with childhood socioeconomic position (father's Registrar General Social Class) were weaker or absent, with the exception of smoking in women. Childhood social position was associated with adult weight in both sexes and with current smoking, waist/height, HDL cholesterol and fibrinogen in women. Height, a measure of health capital or constitution, was weakly linked with father's social class and more strongly linked with own employment grade. The combination of childhood disadvantage (low father's class) together with a low status clerical occupation in men was particularly associated with higher body mass index as an adult (interaction test p < 0.001). Adjustment for earlier socioeconomic position--using father's class and own education level simultaneously--did not weaken the effects of adult socioeconomic position, except in the case of smoking in women, when the grade effect was reduced by 59 per cent. CONCLUSIONS: Cardiovascular risk factors in adulthood were in general more strongly related to adult than to childhood socioeconomic position. Among women but not men there was a strong but unexplained link between father's class and adult smoking habit. In both sexes degree of obesity was associated with both childhood and adulthood social position. These findings suggest that the socially patterned accumulation of health capital and cardiovascular risk begins in childhood and continues, according to socioeconomic position, during adulthood.  相似文献   

19.
OBJECTIVE: To examine socioeconomic differences in obesity using several different socioeconomic indicators, ranging from childhood socioeconomic environment and adult socioeconomic status to material resources and economic satisfaction. RESEARCH METHODS AND PROCEDURES: The data derived from the Helsinki Health Study baseline surveys in 2000 and 2001. Respondents to postal surveys were middle-aged employees of the City of Helsinki (4,975 women and 1,252 men, response rate 68%). Associations between eight socioeconomic indicators and obesity (BMI > or = 30 kg/m(2)), calculated from self-reported data, were examined by fitting a series of logistic regression models. RESULTS: In women, all socioeconomic indicators except household income and economic satisfaction were associated with obesity. Parental education and childhood economic difficulties, i.e., socioeconomic conditions in childhood, remained associated with obesity after adjusting for all indicators of current socioeconomic position. Indicators of adult socioeconomic status, own education and occupational class, were no longer associated with obesity when childhood socioeconomic conditions were adjusted for. Home ownership and economic difficulties were associated with obesity after full adjustments. In men, the findings paralleled those among women, but few associations reached statistical significance. DISCUSSION: Obesity was associated with several dimensions of socioeconomic position. Childhood socioeconomic disadvantage was associated with obesity independently of the various indicators of current socioeconomic position. Associations between obesity and both educational level and occupational class disappeared after adjustment for other indicators of socioeconomic position. This suggests that the variation observed in the prevalence of obesity by these key socioeconomic indicators may reflect differences in the related material resources.  相似文献   

20.
Given limited research on the impact of neighborhood environments on accelerated biological aging, we examined whether changes in neighborhood socioeconomic and social conditions were associated with change in leukocyte telomere length using 10 years of longitudinal data from the Multi-Ethnic Study of Atherosclerosis (years 2000–2011; N = 1031; mean age = 61, SD = 9.4). Leukocyte telomere length change was corrected for regression to the mean and neighborhood was defined as census tract. Neighborhood socioeconomic indicators (factor-based score of income, education, occupation, and wealth of neighborhood) and neighborhood social environment indicators (aesthetic quality, social cohesion, safety) were obtained from the U.S Census/American Community Survey and via study questionnaire, respectively. Results of linear mixed-effects models showed that independent of individual sociodemographic characteristics, each unit of improvement in neighborhood socioeconomic status was associated with slower telomere length attrition over 10-years (β = 0.002; 95% Confidence Interval (CI): 0.0001, 0.004); whereas each unit of increase in safety (β = −0.043; 95% CI: -0.069, −0.016) and overall neighborhood social environment score (β = -0.005; 95% CI: -0.009, −0.0004) were associated with more pronounced telomere attrition, after additionally adjusting for neighborhood socioeconomic status. This study provides support for considerations of the broader social and socioeconomic contexts in relation to biological aging. Future research should explore potential psychosocial mechanisms underlying these associations using longitudinal study designs with repeated observations.  相似文献   

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