背景:越来越多,证据表明,邻里环境的不同方面在自我评估的健康中起着重要作用,高龄的关键健康指标之一。然而,非常老的成年人往往代表不足或被排除在此类研究之外。因此,这项研究的第一个目的是研究社会,社会经济,在德国非常老的人口中,物理邻里环境与自我评估的健康状况有关。第二个目标是探索社区中社会资源的可用性是否可以调节社会经济和物理邻里环境与自我评估健康的联系。
方法:来自代表性调查的数据,“德国老年”(D80+)被雇用。总的来说,D80+的研究样本包括10,578名80岁及以上的个体。此外,D80+数据与联邦建筑研究所的免费区域数据集相匹配,城市事务,和空间发展。使用两个自我评估的项目(地方依恋和社会凝聚力)来评估社会邻里环境。社区的社会经济背景由德国社会经济剥夺指数实施。要评估物理上下文,包括建筑物条件和步行性的感知措施。使用具有鲁棒标准误差的最大似然估计器,估计了逻辑回归模型来分析邻里环境(社会,社会经济,和物理环境,以及他们的互动)和自我评估的健康。
结果:包括8066名参与分析的参与者,调查结果表明,住宅建筑条件较好,更高的步行性,与户外场所紧密相连,和更高的社会凝聚力与更高的机会报告很老的成年人的良好的自我评估的健康相关。在调整后的模型中,德国社会经济剥夺指数与自我评估的健康状况无关。根据可用的邻里社会资源,社会经济和物理邻里环境对自评健康的影响没有差异。
结论:结果表明,在德国非常老的人群中,在社会和物理邻里环境中,尤其是更有利的条件与良好的自我评估健康状况有关。在研究社区对老年人群自我评估健康的影响时,进一步的研究应考虑社区背景的多个方面及其相互作用。
BACKGROUND: Increasingly, evidence has shown that different aspects of neighborhood context play a significant role in self-rated health, one of the key health indicators in advanced age. Nevertheless, very old adults are often under represented or excluded from such research. Therefore, the first aim of this study was to examine whether social, socioeconomic, and physical neighborhood context is associated with self-rated health in the very old population of Germany. The second objective was to explore whether the link of socioeconomic and physical neighborhood context with self-rated health is moderated by availability of social resources in neighborhoods.
METHODS: Data from the representative survey, \"Old Age in Germany\" (D80+) were employed. In total, the study sample of D80+ included 10,578 individuals aged 80 years and over. Additionally, the D80+ data were matched with the freely accessible regional dataset of the Federal Institute for Research on Building, Urban Affairs, and Spatial Development. Two self-rated items (place attachment and social cohesion) were used to assess social neighborhood context. Socioeconomic context of neighborhoods was operationalized by German index of socioeconomic deprivation. To evaluate physical context, perceived measures of building conditions and walkability were included. Using the maximum likelihood estimator with robust standard errors, logistic regression models were estimated to analyze the relationship between neighborhood context (social, socioeconomic, and physical context, as well as their interactions) and self-rated health.
RESULTS: Including 8,066 participants in the analysis, the findings showed that better condition of residential building, higher walkability, being closely attached to outdoor places, and higher social cohesion were associated with higher chance to report good self-rated health of very old adults. In the adjusted models, the German socioeconomic deprivation index was not related to self-rated health. The effect of socioeconomic and physical neighborhood context on self-rated health did not differ according available neighborhood social resources.
CONCLUSIONS: The results indicate that especially more favorable conditions in social and physical neighborhood context are associated with good self-rated health in the very old population of Germany. Further studies should consider multiple aspects of neighborhood context as well as their interplay when examining the neighborhood impact on self-rated health in older populations.