Your home – and where it's located – may affect your health
By Laura Williamson, American Heart Association 沙巴足球体育平台
They say home is where the heart is. 但是，一个人的家是否也会影响心脏的健康程度呢?
A large body of research suggests it can. 专家说，住房——房子的位置以及一个人是否有房子——会对心血管健康产生重大影响, 影响许多风险因素，以及一个人获得维持良好心脏健康所需资源的机会.
“你的邮政编码比任何类型的遗传倾向都更能预测心血管风险,”医生说。. Boback Ziaeian, 他是加州大学大卫·格芬医学院心脏病学部门的医学助理教授, 洛杉矶.
"The environment you live in affects the risk factors you develop, 这些风险因素会累积起来，影响你的健康,他说.
这些因素可能包括获得医生和保健设施的机会, daily stressors such as exposure to violence, pollution and discrimination, attitudes toward health-promoting behaviors and 教育al, recreational and economic opportunities, 博士说. 马里奥•西姆斯, a professor of social medicine, population and public health at the University of California, Riverside School of Medicine. "It's a multilayered problem."
And not one easily solved. Factors outside a person's control may limit their housing options, creating health disparities associated with income and race, 西姆斯说. He was the lead author of a 2020 American Heart Association 科学声明 on the importance of housing for cardiovascular health and well-being. It found 住房稳定, 质量与安全, affordability and accessibility, and neighborhood environment all played a role.
研究表明，结构性种族主义和歧视行为，如划红线, 从历史上看，这使得黑人更难拥有自己的住房，并将他们隔离在资源较少的社区, contribute to poor cardiovascular health and higher mortality rates. A 2014 study published in 循环 将社区层面的种族隔离与黑人心血管疾病风险增加12%联系起来, compared to their white peers.
"You could be segregated away from primary care facilities, which then determines your access to medical care and treatment,西姆斯说.
生活在低收入社区也会影响一个人的教育和就业机会, which in turn affects their earning power, Ziaeian说. 黑人和西班牙裔家庭比白人更有可能住在低收入社区, 哪些社区比高收入社区面临更高的心血管疾病风险. A 最近的研究 in Scientific Reports found the risks for diabetes, 高血压, coronary artery disease, 心脏衰竭, stroke and mortality decreased as socioeconomic status rose.
贫困社区也可能有更高的犯罪率和更少的安全空间来锻炼或体育活动, 西姆斯说. They may lack sidewalks, reducing opportunities to walk around the neighborhood, contributing to a more sedentary lifestyle, 这反过来又会导致肥胖——两种已知的心血管风险因素.
生活在种族隔离的社区也可能影响一个人对医疗保健系统的态度, 他说. 例如, 在历史上以黑人为主的社区，人们可能会在对医学界的不信任中长大, stemming from past events such as the U.S. 公共卫生服务局的塔斯基吉梅毒研究误导了参与研究的黑人，并隐瞒了治疗这种疾病的有效方法.
对健康行为的态度也可能受到一个人的家庭和邻居的影响, 西姆斯说. "They may influence your behaviors directly and indirectly," based on their value systems, such as whether they value exercise, 健康饮食, seeing a doctor regularly or taking needed medications. 吸烟——心血管疾病的一个主要危险因素——在低收入社区也更为普遍.
"When people are socially marginalized and under a lot of strain, they tend to pick up unhealthy habits,齐亚安说.
And people with substance use disorder and addiction, which raise the risk for cardiovascular disease, may be more likely to have unstable housing or no homes at all, 他说.
虽然生活在资源较少的社区可能更难做到这一点, 人们可以采取一些措施来降低患心血管疾病的风险, 西姆斯说.
Research has shown that eating a healthy diet, staying physically active, maintaining a healthy weight, 不吸烟, 保证充足的睡眠——大多数成年人每晚需要7到9个小时——并控制血压, 血糖和胆固醇水平有助于改善和维持良好的心血管健康.
但, 西姆斯说, 如果没有影响收入分配的广泛政策变化，就不会消除与生活地点有关的心血管健康差异, 住房稳定, 教育, neighborhood safety and a myriad of other factors.
“我们需要改变更多可以降低心脏病风险的全身因素,他说, 这需要沙巴足球体育平台. “我们不是一夜之间陷入困境的，也不可能一夜之间摆脱困境."