{"title":"与老年人物质使用、烟草使用和酗酒行为相关的社会环境因素的多水平分析。","authors":"Xue Zhang, Braden K Linn, Jennifer L Moss","doi":"10.1016/j.amepre.2025.108115","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Social environmental factors are associated with risky health behaviors. However, limited research examines these relationships among older adults, and across multiple levels of the social environment.</p><p><strong>Methods: </strong>This study analyzed data from a 2021 survey of older adults (ages 50+ years, n=2774) in the mid-Atlantic region of the US. Using a socioecological framework, the social environment was measured at the levels of the individual (loneliness, resilience, perceived discrimination), interpersonal (emotional social support), neighborhood (attraction to neighborhood, acts of neighboring, sense of belonging), and community (crime, area deprivation, racial residential segregation). Generalized structural equation models were used to examine the pathways from multilevel social environmental factors to risk behaviors (substance misuse, tobacco use, binge drinking), controlling for age, sex, race/ethnicity, marital status, educational level, household income, and metropolitan status. Analyses were conducted in 2024.</p><p><strong>Results: </strong>Individual characteristics, including higher loneliness and discrimination and lower resilience, were associated with a higher likelihood of risk behaviors. Attraction to neighborhood, acts of neighboring, and sense of belonging were indirectly, negatively associated with risk behaviors through their relationships with individual characteristics and social support. However, acts of neighboring and sense of belonging were directly, positively associated with tobacco use and binge drinking. Racial segregation was indirectly, positively associated with risk behaviors via discrimination and neighborhood factors.</p><p><strong>Conclusions: </strong>A multilevel approach is essential for understanding risk behaviors among older adults. Enhancing the built environment to improve neighborhood attractiveness and addressing structural factors that contribute to racial segregation could help reduce risk behaviors in this population.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108115"},"PeriodicalIF":4.5000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A multilevel analysis of social environmental factors related to substance use, tobacco use, and binge drinking behaviors among older adults.\",\"authors\":\"Xue Zhang, Braden K Linn, Jennifer L Moss\",\"doi\":\"10.1016/j.amepre.2025.108115\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Social environmental factors are associated with risky health behaviors. However, limited research examines these relationships among older adults, and across multiple levels of the social environment.</p><p><strong>Methods: </strong>This study analyzed data from a 2021 survey of older adults (ages 50+ years, n=2774) in the mid-Atlantic region of the US. Using a socioecological framework, the social environment was measured at the levels of the individual (loneliness, resilience, perceived discrimination), interpersonal (emotional social support), neighborhood (attraction to neighborhood, acts of neighboring, sense of belonging), and community (crime, area deprivation, racial residential segregation). Generalized structural equation models were used to examine the pathways from multilevel social environmental factors to risk behaviors (substance misuse, tobacco use, binge drinking), controlling for age, sex, race/ethnicity, marital status, educational level, household income, and metropolitan status. Analyses were conducted in 2024.</p><p><strong>Results: </strong>Individual characteristics, including higher loneliness and discrimination and lower resilience, were associated with a higher likelihood of risk behaviors. Attraction to neighborhood, acts of neighboring, and sense of belonging were indirectly, negatively associated with risk behaviors through their relationships with individual characteristics and social support. However, acts of neighboring and sense of belonging were directly, positively associated with tobacco use and binge drinking. Racial segregation was indirectly, positively associated with risk behaviors via discrimination and neighborhood factors.</p><p><strong>Conclusions: </strong>A multilevel approach is essential for understanding risk behaviors among older adults. Enhancing the built environment to improve neighborhood attractiveness and addressing structural factors that contribute to racial segregation could help reduce risk behaviors in this population.</p>\",\"PeriodicalId\":50805,\"journal\":{\"name\":\"American Journal of Preventive Medicine\",\"volume\":\" \",\"pages\":\"108115\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Preventive Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amepre.2025.108115\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2025.108115","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
A multilevel analysis of social environmental factors related to substance use, tobacco use, and binge drinking behaviors among older adults.
Introduction: Social environmental factors are associated with risky health behaviors. However, limited research examines these relationships among older adults, and across multiple levels of the social environment.
Methods: This study analyzed data from a 2021 survey of older adults (ages 50+ years, n=2774) in the mid-Atlantic region of the US. Using a socioecological framework, the social environment was measured at the levels of the individual (loneliness, resilience, perceived discrimination), interpersonal (emotional social support), neighborhood (attraction to neighborhood, acts of neighboring, sense of belonging), and community (crime, area deprivation, racial residential segregation). Generalized structural equation models were used to examine the pathways from multilevel social environmental factors to risk behaviors (substance misuse, tobacco use, binge drinking), controlling for age, sex, race/ethnicity, marital status, educational level, household income, and metropolitan status. Analyses were conducted in 2024.
Results: Individual characteristics, including higher loneliness and discrimination and lower resilience, were associated with a higher likelihood of risk behaviors. Attraction to neighborhood, acts of neighboring, and sense of belonging were indirectly, negatively associated with risk behaviors through their relationships with individual characteristics and social support. However, acts of neighboring and sense of belonging were directly, positively associated with tobacco use and binge drinking. Racial segregation was indirectly, positively associated with risk behaviors via discrimination and neighborhood factors.
Conclusions: A multilevel approach is essential for understanding risk behaviors among older adults. Enhancing the built environment to improve neighborhood attractiveness and addressing structural factors that contribute to racial segregation could help reduce risk behaviors in this population.
期刊介绍：
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
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