Health & Place最新文献_第3页

Understanding heat-driven health risks: Spatiotemporal dynamics and regional vulnerability in new Mexico 了解热驱动的健康风险：新墨西哥州的时空动态和区域脆弱性

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2026-01-01 DOI: 10.1016/j.healthplace.2025.103600

Moongi Choi , Chelsea Eastman Langer , Colin Hawkinson , Melissa VanSickle , Stephanie Moraga-McHaley , Leiqiu Hu , Bonne Ford , Sheryl Magzamen , Jeffrey R. Pierce , Armistead G. Russell , Olivia Sablan , Christopher K. Uejio

As climate change intensifies, heat-related health risks are expected to increase, arising from complex interactions between environmental and social factors. Although prior research has primarily focused on the effects of extreme heat events on heat-related illnesses, the cumulative impact of prolonged summer heat on all-cause hospitalization trends, as well as its spatiotemporal interactions with key heat-risk factors, remains insufficiently understood. This study addresses this gap by examining the relationship between all-cause hospitalization rates and heat-risk factors, including Wet-Bulb Globe Temperature (WBGT), heat-related social vulnerabilities, and PM2.5, in New Mexico from 2016 to 2022. By integrating a spatiotemporal Bayesian model and Self-Organizing Maps (SOM), we identified regional variations in relative risk and analyzed how these factors influenced hospitalization patterns over time and space. Results show that WBGT only becomes positively associated with hospitalizations after considering heat-related social vulnerabilities. Despite declining hospitalization rates over the study period, the increasing relative risk of hospitalization may reflect underlying healthcare access inequalities. SOM clustering highlights distinct regional patterns, where some counties are more influenced by environmental factors while others are driven by heat-related social vulnerabilities. As a result, our findings highlight the need for geographically differentiated interventions that reflect the evolving impact of heat-risk factors, enabling more effective and equitable resource allocation based on each region's dominant drivers of risk.

随着气候变化的加剧，由于环境和社会因素之间复杂的相互作用，预计与热有关的健康风险将增加。尽管先前的研究主要集中在极端高温事件对热相关疾病的影响上，但长期夏季高温对全因住院趋势的累积影响，以及其与关键热风险因素的时空相互作用，仍然没有得到充分的了解。本研究通过研究2016年至2022年新墨西哥州全因住院率与热风险因素（包括湿球温度（WBGT）、热相关社会脆弱性和PM2.5）之间的关系，解决了这一差距。通过整合时空贝叶斯模型和自组织地图（SOM），我们确定了相对风险的区域差异，并分析了这些因素如何随时间和空间影响住院模式。结果表明，在考虑了与热相关的社会脆弱性后，WBGT仅与住院率呈正相关。尽管在研究期间住院率有所下降，但住院相对风险的增加可能反映了潜在的医疗保健不平等。SOM聚类突出了不同的区域模式，其中一些县更多地受到环境因素的影响，而另一些县则受到与热相关的社会脆弱性的影响。因此，我们的研究结果强调需要采取地理上差异化的干预措施，以反映热风险因素的不断变化的影响，从而根据每个地区的主要风险驱动因素实现更有效和公平的资源分配。

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引用次数: 0

A systematic review of green gentrification and mental health 绿色中产阶级化与心理健康的系统回顾

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-26 DOI: 10.1016/j.healthplace.2025.103599

Catherine D. Brown , Alessandro Rigolon , Piper Zdrodowski , Amber L. Pearson

Urban development projects increasingly incorporate greening efforts in underserved communities to improve human health and promote biodiversity. Unfortunately, these efforts can create a paradox whereby target communities do not reap the benefits due to increased property values, and subsequent physical or social-cultural displacement. This process, green gentrification, may negatively affect residents’ mental health. Despite increased urban greening efforts, we currently lack a review evaluating the impacts of green gentrification on mental health. Thus, we systematically reviewed the existing green gentrification-mental health research. Through 16 articles, we identified pathways relating green gentrification exposures to mental health outcomes. For instance, as neighborhoods experience green gentrification, rising housing prices introduce new financial pressures and concerns surrounding housing availability and quality, which can introduce stress. Also, as living expenses increase, there is a change in demographics, which can diminish sense of community and feelings of belonging. Furthermore, the green space itself can serve as a space of exclusion as longtime residents experience barriers to use, which have negative implications for their mental health. Finally, when the new green space provides ecological remediation or restoration, longtime residents may experience anxiety due to fear of exposure to historic contaminants. Still, there were some benefits from the green space as it provides a location for relaxation, enhances neighborhood aesthetics, and even improves sense of community. Because of the popularity of urban greening as a public health solution, researchers could incorporate longitudinal designs and assess potential mediators to better assess the role of green gentrification in mental health.

城市发展项目越来越多地纳入服务不足社区的绿化工作，以改善人类健康和促进生物多样性。不幸的是，这些努力可能造成一种矛盾，即目标社区由于财产价值增加而无法获得利益，从而导致物质或社会文化流离失所。这个过程，绿色高档化，可能会对居民的心理健康产生负面影响。尽管城市绿化的努力有所增加，但我们目前缺乏评估绿色高档化对心理健康影响的综述。因此，我们系统地回顾了现有的绿色高档化-心理健康研究。通过16篇文章，我们确定了绿色高档化暴露与心理健康结果相关的途径。例如，随着社区经历绿色中产阶级化，房价上涨带来了新的财务压力，以及对住房供应和质量的担忧，这可能会带来压力。此外，随着生活费用的增加，人口结构也发生了变化，这可能会削弱社区意识和归属感。此外，绿地本身可以作为一个排斥空间，因为长期居民使用障碍，这对他们的心理健康有负面影响。最后，当新的绿地提供生态修复或修复时，长期居民可能会因为害怕暴露于历史污染物而感到焦虑。尽管如此，绿色空间也有一些好处，因为它提供了一个放松的场所，增强了社区美学，甚至提高了社区意识。由于城市绿化作为一种公共卫生解决方案的普及，研究人员可以结合纵向设计和评估潜在的中介，以更好地评估绿色中产阶级化在心理健康中的作用。

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引用次数: 0

Navigating contested terrain: How place meanings shape health after homelessness 导航有争议的地形：地方意义如何影响无家可归后的健康。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-23 DOI: 10.1016/j.healthplace.2025.103598

Maja Lindegaard Moensted , Sophie Lewis , Paul Haber , Carolyn Day

引用次数: 0

Investigating the factors associated with preterm birth using evidence from the Growing Up in New Zealand cohort: a retrospective geospatial study 利用新西兰成长队列的证据调查与早产相关的因素：一项回顾性地理空间研究。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-23 DOI: 10.1016/j.healthplace.2025.103597

Cristal Salatas , Matt Hobbs , Frank H. Bloomfield , Tanith Alexander , Clare R. Wall

Background

Preterm birth (PTB) is a major public health concern with multifactorial causes. Modifiable factors, including nutrition and environmental influences, present opportunities for targeted intervention. This study examined associations between sociodemographic, nutritional, and environmental factors and PTB in a cohort of New Zealand (NZ) women.

Method

Data from 6822 mothers in the Growing Up in New Zealand cohort (2009–2010) were analysed to assess associations between sociodemographic characteristics, adherence to NZ food and nutrition guidelines, dietary patterns, micronutrient supplementation, and environmental factors (Healthy Location Index [HLI]) with PTB. Logistic and multilevel models were applied using RStudio.

Results

Of 6667 births, 436 (6.6 %) were preterm. Most sociodemographic factors, including maternal age, parity, BMI, ethnicity, and area-level deprivation, were not significantly associated with PTB. Non-adherence to breads and cereals Ministry of Health guidelines reduced odds (OR = 0.64; 95 % CI: 0.43, 0.91; p = 0.01), while a ‘Junk’ dietary pattern (OR = 1.28; 95 % CI: 1.07, 1.52; p = 0.007) and not taking iron supplements after the first trimester (OR = 1.46; 95 % CI: 1.06, 2.00; p = 0.02) increased odds. Residing in rural areas with moderate urban influence also increased odds (OR = 2.44; 95 % CI: 1.18, 4.66; p = 0.01). HLI demonstrated no significant associations.

Conclusions

Adherence to recommended food groups (breads and cereals), junk dietary patterns, low iron supplement intake after the first trimester, and rural residence with moderate urban influence were associated with increased PTB odds. Addressing maternal nutrition and geographic disparities could help mitigate this risk.

背景：早产（PTB）是一个多因素引起的重大公共卫生问题。可改变的因素，包括营养和环境影响，为有针对性的干预提供了机会。本研究在新西兰（NZ）妇女队列中调查了社会人口统计学、营养和环境因素与肺结核之间的关系。方法：分析来自新西兰成长队列（2009-2010）的6822名母亲的数据，以评估社会人口统计学特征、对新西兰食物和营养指南的遵守、饮食模式、微量营养素补充和环境因素（健康位置指数[HLI]）与PTB之间的关系。使用RStudio进行Logistic和多层模型分析。结果：6667例新生儿中，早产436例（6.6 %）。大多数社会人口因素，包括产妇年龄、胎次、体重指数、种族和地区贫困，与肺结核没有显著相关性。没有遵守面包和谷类食品卫生部指南几率减少(或 = 0.64;95 % CI: 0.43, 0.91; p = 0.01),而“垃圾”饮食模式(或 = 1.28;95 % CI: 1.07, 1.52; p = 0.007),而不是服用铁补充剂在妊娠前三个月(或 = 1.46;95 % CI: 1.06, 2.00; p = 0.02)几率增加。居住在中等城市影响的农村地区也增加了患病几率（OR = 2.44;95 % CI: 1.18, 4.66; p = 0.01）。HLI显示无显著相关性。结论：坚持推荐的食物组（面包和谷物）、垃圾饮食模式、妊娠早期后低铁补充剂摄入量以及中等城市影响的农村居住与PTB风险增加有关。解决产妇营养和地域差异问题有助于减轻这一风险。

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引用次数: 0

How public open spaces co-construct solitary experiences in densely populated urban environments 公共开放空间如何在人口密集的城市环境中共同构建孤独体验

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-20 DOI: 10.1016/j.healthplace.2025.103596

Xia Bi , Yi Izzy Jian , Caterina Villani , Ka Yan Leung , Kin Wai Michael Siu

Loneliness in high-density cities is increasingly being recognised as a public health crisis, but the role of built environments in shaping the feelings of loneliness and solitary experiences remains underexplored. This study investigates how socio-material networks in Hong Kong's public open spaces (POSs) co-construct solitary experiences and contribute to emotional well-being. Using a mixed-methods approach, including individual-centred behavioural mappings, on-site ethnographic interviews (n = 84), and multi-sensory experiential observations, this research reveals that POSs function as emotional refuges, enabling individuals to seek solitude for enjoyment, to escape domestic constraints, and to pause, rest, and reflect. The findings show that solitary experiences emerge through the interplay of human and non-human actants, including people, cultural norms, spatial settings, and environmental conditions. Spatial affordances such as shaded seating, visual seclusion, and proximity to transport networks significantly influence solitary practices. Moreover, POSs frequently serve as complements to other environments, offering respite from overcrowded and stressful home conditions and fast-paced working environments. This study highlights the need for urban planners to recognise solitude as a legitimate and valuable public space experience. It calls for POS designs that incorporate diverse spatial features to support both solitude and sociality, and it advocates for relational perspectives on socio-material networks in research and policy-making to address the emotional complexities of urban life.

高密度城市中的孤独感越来越被认为是一种公共卫生危机，但建筑环境在塑造孤独感和孤独体验方面的作用仍未得到充分探讨。本研究探讨香港公共开放空间（POSs）的社会-物质网络如何共同建构孤独体验并促进情感健康。本研究采用混合方法，包括以个人为中心的行为映射、现场人种学访谈（n = 84）和多感官体验观察，揭示了POSs作为情感避难所的功能，使个人能够寻求独处享受，逃避家庭约束，并暂停、休息和反思。研究结果表明，孤独体验是通过人类和非人类行为的相互作用而产生的，包括人、文化规范、空间设置和环境条件。空间上的便利条件，如遮荫座位、视觉隔离和靠近交通网络等，对独居行为有显著影响。此外，pos经常作为其他环境的补充，从过度拥挤和紧张的家庭条件和快节奏的工作环境中得到喘息。这项研究强调了城市规划者需要认识到孤独是一种合法的、有价值的公共空间体验。它呼吁POS设计结合不同的空间特征，以支持孤独和社交，并倡导在研究和决策中对社会-物质网络的关系观点，以解决城市生活的情感复杂性。

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引用次数: 0

Gendered impacts of public transport on social isolation and loneliness among older adults: Evidence from a natural experiment in Hong Kong 公共交通对老年人社会隔离和孤独感的性别影响：来自香港自然实验的证据

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-18 DOI: 10.1016/j.healthplace.2025.103593

Guibo Sun , Yao Du , Tim Schwanen

A well-designed public transport system has the potential to support social participation and alleviate social isolation and loneliness among older adults. However, limited research has explored whether such benefits differ between older men and women. Using a natural experiment involving a new metro line in Hong Kong, our cohort study (N = 449) of older people yields a surprising finding: contrary to previous studies suggesting that women are more likely than men to experience social isolation and loneliness, our analysis reveals that older men report higher levels of both. Despite this, the new metro line has not significantly reduced social isolation or loneliness among older men. In contrast, older women have actively engaged with the new metro line, especially for those with greater social participation at the baseline, leveraging it to strengthen their social networks and mitigate social isolation and loneliness. These findings suggest that public transport may not equally benefit all groups, underscoring the importance of considering gender differences, particularly the needs of older men, in transport planning to reduce social isolation and loneliness.

设计良好的公共交通系统有可能支持社会参与，减轻老年人的社会孤立和孤独感。然而，有限的研究已经探讨了老年男性和老年女性的这些益处是否不同。利用香港一条新地铁线的自然实验，我们对老年人的队列研究（N = 449）得出了一个惊人的发现：与之前的研究表明女性比男性更有可能经历社会孤立和孤独相反，我们的分析显示，老年男性报告的这两种情况的水平更高。尽管如此，新的地铁线路并没有显著减少老年男性的社会孤立或孤独。相比之下，老年妇女积极参与新的地铁线路，特别是那些在底层社会参与度较高的妇女，利用它来加强她们的社会网络，减轻社会孤立和孤独感。这些调查结果表明，公共交通可能不会平等地惠及所有群体，这强调了在交通规划中考虑性别差异，特别是老年男子的需求，以减少社会孤立和孤独的重要性。

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引用次数: 0

Evaluating regional variation in neighbourhood socioeconomic inequalities in motor vehicle injury collisions 评估机动车伤害碰撞中邻里社会经济不平等的区域差异

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-12 DOI: 10.1016/j.healthplace.2025.103586

Michael Branion-Calles , Somayeh Momenyan , Shannon Erdelyi , Herbert Chan , Kevin Manaugh , Meghan Winters , M. Anne Harris , Jeffrey R. Brubacher

Disadvantaged communities have higher rates of traffic injury. Our goal was to measure regional variation in the association between small-area socioeconomic deprivation and motor vehicle crashes resulting in injury within British Columbia, Canada.

We analyzed road traffic injury crashes from universal auto insurance claims (2019–2023) across 16 urban regions of British Columbia, aggregated by census dissemination areas (DAs). We measured socioeconomic deprivation using the Vancouver Area Neighbourhood Deprivation Index, a normalized score combining seven health-related sociodemographic variables applied to the 2021 Canadian census. We examined associations between deprivation and three injury crash types (motor vehicle, bicycle-motor vehicle, and pedestrian-motor vehicle) using Bayesian spatial regression models.

Increased socioeconomic deprivation was consistently associated with higher injury crash incidence across all crash types, with regional variation in the strength of the relationship. Among the most populous regions, a one standard deviation increase in deprivation was associated with injury crash increases from 17 % (95 % Credible Interval [CI]: 12 %–21 %) in Vancouver-Fraser Valley to 51 % (95 % CI: 36 %–68 %) in the Okanagan region. Similar patterns were observed for cyclist injuries, from 10 % (95 % CI: 4 %–16 %) in Vancouver-Fraser Valley to 64 % (95 % CI: 38 %–93 %) in Okanagan, and for pedestrian injuries, from 17 % (95 % CI: 11 %–24 %) in Vancouver-Fraser Valley to 77 % (95 % CI: 48 %–110 %) in Okanagan. Smaller regions had wide credible intervals and more uncertainty in associations.

To address spatial inequalities, prioritization of the placement of road safety interventions should incorporate equity considerations, as well as area-level interventions that address fundamental risk factors of traffic volume and speed.

弱势群体的交通伤害率更高。我们的目标是测量加拿大不列颠哥伦比亚省小地区社会经济剥夺与机动车碰撞造成伤害之间关系的区域差异。我们分析了不列颠哥伦比亚省16个城市地区的通用汽车保险索赔（2019-2023）的道路交通伤害事故，并按人口普查传播区（DAs）汇总。我们使用温哥华地区邻里剥夺指数来衡量社会经济剥夺，这是一个标准化得分，结合了七个与健康相关的社会人口变量，应用于2021年加拿大人口普查。我们使用贝叶斯空间回归模型研究了剥夺与三种伤害碰撞类型（机动车、自行车机动车和行人-机动车）之间的关系。在所有类型的碰撞中，社会经济剥夺的增加始终与更高的伤害碰撞发生率相关，并且这种关系的强度在区域上存在差异。在人口最多的地区，剥夺的一个标准差增加与伤害事故的增加有关，从温哥华-菲沙河谷的17 %（95 %可信区间[CI]: 12 % -21 %）增加到奥肯那根地区的51 %（95 % CI: 36 % -68 %）。类似的模式观察骑自行车受伤,从10 %(95 % CI: 4 % -16 %)Vancouver-Fraser山谷中64 %(95 % CI: 38 % -93 %)在欧垦那根,行人受伤,从17 %(95 %置信区间:11 % -24 %)Vancouver-Fraser山谷中77 %(95 % CI: 48 % -110 %)在加拿大。较小的区域具有较宽的可信区间和更大的关联不确定性。为了解决空间不平等问题，道路安全干预措施的优先安排应考虑到公平因素，以及解决交通量和速度等根本风险因素的区域一级干预措施。

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引用次数: 0

Understanding the systems dynamics of neighborhood socioeconomic inequities in health in European cities: a causal loop diagram 了解欧洲城市社区卫生方面社会经济不平等的系统动态：因果循环图

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-10 DOI: 10.1016/j.healthplace.2025.103595

Vernon Cail , Mariëlle A. Beenackers , Fleur ter Ellen , Mariël Droomers , Martin Dijst , Joost Oude Groeniger , Frank J. van Lenthe

Urban neighborhood inequities in health remain a persistent public health issue, despite many efforts to promote health equity. Given the complex nature of these inequities, a complex systems science approach is essential to identify and understand their underlying causes. In this study, a causal loop diagram (CLD) was developed to visualize the underlying mechanisms contributing to urban neighborhood inequities in self-assessed health. The CLD was based on the results from a scoping literature review and the input from an interdisciplinary group of researchers. Three overarching themes were identified: 1) Uneven power dynamic in decision-making, 2) Socioeconomic sorting through environmental factors, 3) Mutual reinforcement of social cohesion and the physical environment. The interplay of these themes demonstrates that addressing neighborhood inequities in health requires an integrated approach that is inclusive in the decision-making processes and empowers communities.

尽管为促进卫生公平作出了许多努力，但城市社区在卫生方面的不平等仍然是一个持续存在的公共卫生问题。鉴于这些不平等的复杂性，复杂系统科学方法对于确定和理解其根本原因至关重要。在本研究中，我们开发了一个因果循环图（CLD）来可视化导致城市邻里自我评估健康不平等的潜在机制。CLD是基于范围文献综述的结果和一个跨学科研究小组的输入。研究确定了三个主要主题：1)决策中的权力动态不平衡；2)环境因素对社会经济的影响；3)社会凝聚力和自然环境的相互强化。这些主题的相互作用表明，解决邻里卫生不平等问题需要在决策过程中采取综合办法，并赋予社区权力。

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引用次数: 0

A synthesis of explanations for spatial inequalities in gambling harm: integrating social and material dimensions of place 赌博危害空间不平等的综合解释：整合地方的社会和物质维度

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-05 DOI: 10.1016/j.healthplace.2025.103574

Katie Powell , Laura Fenton , Elizabeth McGill , Saima Nazir-Desforges , Mark Clowes , Abigail Kate Stevely , Cheryl McQuire , Paige M. Hulls , Zoe L. Clarke , Michael P. Daly , Matt Egan , Frank de Vocht

Place matters for understanding patterns of gambling harm as shown by the spatial clustering of both ‘vulnerable’ people and gambling outlets. Harms are experienced at a community level (and never restricted to individuals) and are spread unequally across communities of place. Following the liberalisation of gambling laws in the UK in the 1990s, gambling outlets and advertising have proliferated in many economically disadvantaged places, with the gambling industries in some cases appearing to target these areas. Despite growing recognition of place-based inequalities in the harms caused by gambling, there have been limited efforts to understand gambling as a spatial practice that reflects and produces inequalities in health. This paper presents a synthesis of theories and explanations in the social science and public health literature about the unequal harms from gambling experienced by people in different places. We draw on a socio-material approach in our synthesis to show how different assemblages of gambling products, venues, marketing materials and collective histories form in different localities to influence different gambling practices with varying consequences for health. The synthesis foregrounds how different levels of power and influence in the production, regulation and experience of space across communities shape i) the meanings of gambling as a social practice and ii) the collective resources of communities to protect themselves from gambling harms. The analysis thus points to socio-material spaces as sites for interventions to reduce inequalities in harm.

从“弱势”人群和赌博场所的空间聚类可以看出，地点对于理解赌博危害的模式很重要。危害是在社区层面上经历的（从不局限于个人），并且在社区中不平等地传播。随着20世纪90年代英国赌博法律的自由化，赌博网点和广告在许多经济上处于不利地位的地方激增，在某些情况下，博彩业似乎针对这些地区。尽管越来越多的人认识到赌博造成的危害在地域上的不平等，但将赌博理解为一种反映和产生健康不平等的空间做法的努力有限。本文综合了社会科学和公共卫生文献中的理论和解释，介绍了不同地方的人们在赌博中所经历的不平等伤害。在我们的综合中，我们利用社会物质方法来展示赌博产品、场地、营销材料和集体历史在不同地方形成的不同组合如何影响不同的赌博行为，对健康产生不同的后果。综合展望了不同程度的权力和影响如何在生产，管理和经验的空间跨社区塑造i)赌博作为一种社会实践的意义和ii)社区的集体资源，以保护自己免受赌博伤害。因此，该分析指出，社会物质空间是减少不平等伤害的干预场所。

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引用次数: 0

Geographic dimensions of gastric cancer risk in western Honduras: A spatial ecological analysis 洪都拉斯西部胃癌风险的地理维度：空间生态学分析。

IF 4.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health & Place

Pub Date : 2025-12-02 DOI: 10.1016/j.healthplace.2025.103589

Katerina E.B. Beach , Dalton A. Norwood , Ricardo L. Dominguez , Eleazar Montalvan-Sanchez , Paul Delamater , Scott M. Williams , Douglas R. Morgan , Michael Emch

Gastric cancer is fifth most common cancer globally, with a complex and multifactorial etiology, including human and bacterial genetics, health behaviors, and environmental exposures. Honduras has among the highest rates of gastric cancer in the western hemisphere, and previous research indicates that gastric cancer risk varies geographically at a sub-national scale. We analyzed characteristics of all 788 incident cases diagnosed in western Honduras between 2002 and 2015 for which residence information was available to assess geographic patterns of excess risk and population-level risk factors. We built hierarchal Bayesian Poisson models to implement spatial ecological analysis stratified by sex and gastric cancer sub-type (diffuse, intestinal, mixed/indeterminate) to explore sex and sub-type specific etiologies. We identified differential geospatial patterns of high observed relative risk (i.e., greater than 1.0) for across male/female and diffuse/intestinal strata. Unexplained variance was more spatially structured in models for males, but less so among females, suggesting that unobserved, spatially autocorrelated factors contributing to geographic risk patterns among males in this area. Additionally, ecological associations varied by sex/sub-type strata. Among males, risk of intestinal gastric cancer was elevated with an increase in the percentage of indigenous Maya/Chortí in the population, but this association was not detected in female strata. Our findings demonstrated substantial differences in geographic patterns of risk across sex and ancestry, which implicated that unobserved, sex-stratified factors, such as germline mutations and behaviors, play a role in shaping geographic patterns of cancer risk at the subnational level in western Honduras.

胃癌是全球第五大常见癌症，其病因复杂且多因素，包括人类和细菌遗传、健康行为和环境暴露。洪都拉斯是西半球胃癌发病率最高的国家之一，以前的研究表明，胃癌风险在次国家范围内存在地理差异。我们分析了2002年至2015年间在洪都拉斯西部诊断的所有788例事件病例的特征，这些病例的居住信息可用于评估过度风险的地理模式和人口水平的风险因素。建立分层贝叶斯泊松模型，按性别和胃癌亚型（弥漫性、肠型、混合型/不确定型）分层进行空间生态分析，探索性别和亚型特异性病因。我们确定了男性/女性和弥漫性/肠层之间观察到的高相对风险（即大于1.0）的不同地理空间模式。在男性模型中，无法解释的变异在空间上更为结构化，而在女性模型中则较少，这表明未观察到的空间自相关因素对该地区男性的地理风险模式有影响。此外，不同性别/亚类型地层的生态关联也不同。在男性中，肠道胃癌的风险随着人口中土著玛雅人/Chortí比例的增加而增加，但在女性阶层中没有发现这种关联。我们的研究结果表明，不同性别和血统的癌症风险地理模式存在显著差异，这意味着未观察到的性别分层因素，如生殖系突变和行为，在洪都拉斯西部次国家层面的癌症风险地理模式形成中发挥了作用。

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引用次数: 0