PDF(Pubmed)
Abstract：
People aging with disability may be limited in their ability to engage in healthy behaviors to maintain cardiometabolic health. We investigated the role of health promoting features in the neighborhood environment for incident cardiometabolic disease in adults aging with physical disability in the United States.
Retrospective cohort study.
Optum\'s Clinformatics® Data Mart Database (2007-2018) of administrative health claims.
ICD-9-CM codes were used to identify 15 467 individuals with a diagnosis of Cerebral Palsy, Spina Bifida, Multiple Sclerosis, or Spinal Cord Injury.
Cardiometabolic disease was identified using ICD-9-CM/ICD-10-CM codes over 3 years of follow-up. Measures of the neighborhood environment came from the National Neighborhood Data Archive and linked to individual residential ZIP codes over time. Covariates included age, sex, and comorbid health conditions.
Cox regression models estimated hazard ratios (HR) for incident cardiometabolic disease. Using a 1-year lookback period, individuals with pre-existing cardiometabolic disease were excluded from the analysis.
Net of individual risk factors, residing in neighborhoods with a greater density of broadband Internet connections (HR = .88, 95% CI: .81, .97), public transit stops (HR = .89, 95% CI: .83, .95), recreational establishments (HR = .89, 95% CI: .83, .96), and parks (HR = .88, 95% CI: .82, .94), was associated with reduced risk of 3-year incident cardiometabolic disease.
Findings identify health-promoting resources that may mitigate health disparities in adults aging with disability.
Retrospective cohort study.
Optum\'s Clinformatics® Data Mart Database (2007-2018) of administrative health claims.
ICD-9-CM codes were used to identify 15 467 individuals with a diagnosis of Cerebral Palsy, Spina Bifida, Multiple Sclerosis, or Spinal Cord Injury.
Cardiometabolic disease was identified using ICD-9-CM/ICD-10-CM codes over 3 years of follow-up. Measures of the neighborhood environment came from the National Neighborhood Data Archive and linked to individual residential ZIP codes over time. Covariates included age, sex, and comorbid health conditions.
Cox regression models estimated hazard ratios (HR) for incident cardiometabolic disease. Using a 1-year lookback period, individuals with pre-existing cardiometabolic disease were excluded from the analysis.
Net of individual risk factors, residing in neighborhoods with a greater density of broadband Internet connections (HR = .88, 95% CI: .81, .97), public transit stops (HR = .89, 95% CI: .83, .95), recreational establishments (HR = .89, 95% CI: .83, .96), and parks (HR = .88, 95% CI: .82, .94), was associated with reduced risk of 3-year incident cardiometabolic disease.
Findings identify health-promoting resources that may mitigate health disparities in adults aging with disability.
摘要：
目的：老年残疾患者从事健康行为以维持心脏代谢健康的能力可能受到限制。我们调查了健康促进特征在美国老年人身体残疾的心脏代谢疾病中的作用。
方法：回顾性队列研究。
方法：Optum的Clinformatics®DataMart行政健康索赔数据库（2007-2018）。
方法：ICD-9-CM代码用于识别15.467名诊断为脑瘫的个体，脊柱裂,多发性硬化症,或脊髓损伤。
方法：在3年的随访中，使用ICD-9-CM/ICD-10-CM编码鉴定出心脏代谢疾病。邻里环境的度量来自国家邻里数据档案馆，并随着时间的推移与个人住宅邮政编码相关联。协变量包括年龄，性别,和合并症的健康状况。
方法：Cox回归模型估计心血管代谢疾病的风险比（HR）。使用1年的回顾期，既往有心脏代谢疾病的个体被排除在分析之外.
结果：单个风险因素净值，居住在宽带互联网连接密度更大的社区(HR=.88，95%CI:.81，.97)，公共交通站点(HR=.89，95%CI：.83，.95)，康乐场所(HR=.89，95%CI：.83，.96)，和公园(HR=.88，95%CI：.82，.94)，与降低3年心血管疾病的风险相关.
结论：研究发现了促进健康的资源，这些资源可能会减轻残疾老年人的健康差异。
方法：回顾性队列研究。
方法：Optum的Clinformatics®DataMart行政健康索赔数据库（2007-2018）。
方法：ICD-9-CM代码用于识别15.467名诊断为脑瘫的个体，脊柱裂,多发性硬化症,或脊髓损伤。
方法：在3年的随访中，使用ICD-9-CM/ICD-10-CM编码鉴定出心脏代谢疾病。邻里环境的度量来自国家邻里数据档案馆，并随着时间的推移与个人住宅邮政编码相关联。协变量包括年龄，性别,和合并症的健康状况。
方法：Cox回归模型估计心血管代谢疾病的风险比（HR）。使用1年的回顾期，既往有心脏代谢疾病的个体被排除在分析之外.
结果：单个风险因素净值，居住在宽带互联网连接密度更大的社区(HR=.88，95%CI:.81，.97)，公共交通站点(HR=.89，95%CI：.83，.95)，康乐场所(HR=.89，95%CI：.83，.96)，和公园(HR=.88，95%CI：.82，.94)，与降低3年心血管疾病的风险相关.
结论：研究发现了促进健康的资源，这些资源可能会减轻残疾老年人的健康差异。
