Quantifying Neighbourhood Socioeconomic Effects in Clustering of Behaviour-Related Risk Factors A Multilevel Analysis 英文参考文献.docVIP

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Quantifying Neighbourhood Socioeconomic Effects in Clustering of Behaviour-Related Risk Factors A Multilevel Analysis 英文参考文献.doc

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Quantifying Neighbourhood Socioeconomic Effects in Clustering of Behaviour-Related Risk Factors A Multilevel Analysis 英文参考文献

QuantifyingNeighbourhoodSocioeconomicEffectsin ClusteringofBehaviour-RelatedRiskFactors:A MultilevelAnalysis JaanaI.Halonen1*,MikaKivima¨ki1,2.,JaanaPentti1,IchiroKawachi3,MariannaVirtanen1, PekkaMartikainen4,S.V.Subramanian3,JussiVahtera1,5. 1FinnishInstituteofOccupationalHealth,Helsinki,Finland,2DepartmentofEpidemiologyandPublicHealth,UniversityCollegeLondonMedicalSchool,London,United Kingdom,3DepartmentofSociety,HumanDevelopment,andHealth,HarvardSchoolofPublicHealth,Boston,Massachusetts,UnitedStatesofAmerica,4Population ResearchUnit,DepartmentofSocialResearch,UniversityofHelsinki,Helsinki,Finland,5DepartmentofPublicHealth,UniversityofTurku,andTurkuUniversityHospital, Turku,Finland Abstract Background: The extent to which neighbourhood characteristics explain accumulation of health behaviours is poorly understood.Weexaminedwhetherneighbourhooddisadvantagewasassociatedwithco-occurrenceofbehaviour-related risk factors, and how much of the neighbourhood differences in the co-occurrence can be explained by individual and neighbourhoodlevelcovariates. Methods: The study population consisted of 60694 Finnish Public Sector Study participants in 2004 and 2008. Neighbourhood disadvantage was determined using small-area level information on household income, education attainment, and unemployment rate, and linked with individual data using Global Positioning System-coordinates. Associations between neighbourhood disadvantage and co-occurrence of three behaviour-related risk factors (smoking, heavyalcoholuse,andphysicalinactivity),andtheextenttowhichindividualandneighbourhoodlevelcovariatesexplain neighbourhooddifferencesinco-occurrenceofriskfactorsweredeterminedwithmultilevelcumulativelogisticregression. Results:Afteradjustingforage,sex,maritalstatus,andpopulationdensitywefoundadose-responserelationshipbetween neighbourhooddisadvantageandco-occurrenceofriskfactorswithineachlevelofindividualsocioeconomicstatus.The cumulativeoddsratiosforthesumofhealthriskscomparingthemost