Résumé :
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[BDSP. Notice produite par INIST-CNRS JR0xHI79. Diffusion soumise à autorisation]. The authors examined the impact of cumulative neighborhood risk of psychosocial stress on allostatic load (AL) among adolescents as a mechanism through which life stress, including neighborhood conditions, may affect health and health inequities. They conducted multilevel analyses, weighted for sampling and propensity score-matched, among adolescents aged 12-20 years in the National Health and Nutrition Examination Survey (1999-2006). Individuals (first level, n=11,886) were nested within families/households (second level, n=6,696) and then census tracts (third level, n=2,191) for examination of the contextual effect of cumulative neighborhood risk environment on AL. Approximately 35% of adolescents had 2 or more biomarkers of AL. A significant amount of variance in AL was explained at the neighborhood level. The likelihood of having a high AL was approximately 10% higher for adolescents living in medium-cumulative-risk neighborhoods (adjusted odds ratio (OR)=1.09,95% confidence interval (CI) : 1.08,1.09), 28% higher for those living in high-risk neighborhoods (adjusted OR=1.28,95% CI : 1.27,1.30), and 69% higher for those living in very-high-risk neighborhoods (adjusted OR=1.69,95% CI : 1.68,1.70) as compared with adolescents living in low-risk areas. Effect modification was observed by both individual-and neighborhood-level sociodemographic factors. These findings offer support for the hypothesis that neighborhood risks may culminate in a range of biologically mediated negative health outcomes detectable in adolescents.
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