Table 3.
Factors Associated With Allostatic Load (≥2 Biomarkers) in Hierarchical Logistic Regression Models (1,958 Census Tracts, 8,851 Adolescents), National Health and Nutrition Examination Survey, 1999–2006a
| Variable | Model A: Empty Model |
Model B: Model With Cumulative Neighborhood Risk |
Model C: Model
With ICE + Other Covariates |
Model D: Model With Cumulative Neighborhood Risk + Other Covariates |
Model E: Model With Cumulative Risk and ICE (Potential Mediation) |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | % | OR | 95% CI | % | OR | 95% CI | % | OR | 95% CI | % | OR | 95% CI | % | |
| Individual-level variables | |||||||||||||||
| Female sex | 0.87 | 0.86, 0.88 | 0.87 | 0.86, 0.88 | 0.80 | 0.80, 0.81 | |||||||||
| Age, years | 1.07 | 1.06, 1.08 | 1.05 | 1.05, 1.05 | 1.04 | 1.04, 1.05 | |||||||||
| Race/ethnicity and PIR | |||||||||||||||
| Non-Hispanic white and PIR ≥1 (referent) | 1.00 | 1.00 | 1.00 | ||||||||||||
| Minority and PIR ≥1 | 1.04 | 1.03, 1.04 | 1.02 | 1.01, 1.02 | 1.02 | 1.01, 1.02 | |||||||||
| Non-Hispanic white and PIR <1 | 1.15 | 1.14, 1.17 | 1.22 | 1.21, 1.23 | 1.22 | 1.21, 1.23 | |||||||||
| Minority and PIR <1 | 1.11 | 1.10, 1.12 | 1.12 | 1.11, 1.13 | 1.12 | 1.11, 1.13 | |||||||||
| Physical activity (none, moderate, or vigorous) | 0.91 | 0.91, 0.92 | 0.90 | 0.89, 0.91 | 0.90 | 0.89, 0.91 | |||||||||
| Healthy Eating Index scoreb | 0.99 | 0.98, 0.99 | 0.98 | 0.97, 0.99 | 0.98 | 0.97, 0.99 | |||||||||
| Currently having an infection | 1.19 | 1.19, 1.20 | 1.31 | 1.30, 1.32 | 1.31 | 1.30, 1.32 | |||||||||
| Survey cycle (cycle 1 (1999–2000) to cycle 4 (2005–2006)) | 1.11 | 1.11, 1.12 | 1.11 | 1.11, 1.12 | 1.11 | 1.11, 1.12 | |||||||||
| Household-level variables | |||||||||||||||
| Adult respondent education (<HS, HS/GED, >HS) | 0.71 | 0.70, 0.72 | 0.72 | 0.71, 0.73 | 0.72 | 0.71, 0.73 | |||||||||
| Adult respondent marital status (married vs. not married) | 0.51 | 0.50, 0.52 | 0.65 | 0.65, 0.66 | 0.65 | 0.65, 0.66 | |||||||||
| No. of years of residence in neighborhood | 1.01 | 1.01, 1.02 | 1.01 | 1.01, 1.02 | 1.01 | 1.01, 1.02 | |||||||||
| Adult respondent allostatic load score | 1.12 | 1.11, 1.13 | 1.13 | 1.12, 1.13 | 1.13 | 1.12, 1.13 | |||||||||
| Census tract-level variables | |||||||||||||||
| Cumulative neighborhood risk | |||||||||||||||
| Low (referent) (0 risk factors) | 1.00 | 1.00 | 1.00 | ||||||||||||
| Medium (1–2 risk factors) | 1.16 | 1.16, 1.17 | 1.09 | 1.08, 1.09 | 1.05 | 1.01, 1.09 | |||||||||
| High (3–4 risk factors) | 1.37 | 1.36, 1.37 | 1.28 | 1.27, 1.30 | 1.26 | 1.25, 1.28 | |||||||||
| Very high (>4 risk factors) | 1.84 | 1.83, 1.85 | 1.69 | 1.68, 1.70 | 1.36 | 1.35, 1.36 | |||||||||
| ICEc | 0.96 | 0.93, 0.98 | 0.97 | 0.95, 0.99 | |||||||||||
| Urbanicity (urban census tract vs. rural census tract) | 0.83 | 0.82, 0.83 | 0.80 | 0.79, 0.81 | 0.79 | 0.79, 0.80 | |||||||||
| Random effectsd | |||||||||||||||
| Household ICC | 41.35 | 40.09 | 25.34 | 25.52 | 25.53 | ||||||||||
| Neighborhood ICC | 6.23 | 2.71 | 4.61 | 2.10 | 2.09 | ||||||||||
| Neighborhood median OR | 2.20 | 1.47 | 1.92 | 1.45 | 1.42 | ||||||||||
Abbreviations: CI, confidence interval; GED, General Educational Development; HS, high school; ICC, intraclass correlation coefficient; ICE, index of concentration at the extremes; OR, odds ratio; PIR, poverty:income ratio.
a All models were based on frequency-matching of propensity score, or propensity to live in a high- or very-high-cumulative-risk neighborhood (≥3 risk factors) versus a medium- (1–2 risk factors) or low- (0 risk factors) cumulative-risk neighborhood. Results were similar when allostatic load was examined as a continuous outcome.
b Healthy Eating Index scores ranged from 0 to 100, with a total score of more than 80 considered “good,” scores of 51–80 indicating “needs improvement,” and scores less than 51 considered “poor.”
c ICE = number of college graduates – number with no high school diploma/total population) × 100.
d Individual-level variance was calculated using the formula of Snijders and Boskers (38) on the basis of an underlying continuous variable with Vindividual = П2/3. Because of the limitations of the ICC with regard to nonlinear outcomes, the median OR (37) was also calculated.