Fundamental cause theory, technological innovation, and health disparities: the case of cholesterol in the era of statins.

Fundamental cause theory, technological innovation, and health disparities: the case of cholesterol in the era of statins.
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DOI:
10.1177/002214650905000301
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发表时间:
2009-09
影响因子:
5
通讯作者:
Lauderdale DS
Lauderdale DS
中科院分区:
医学2区
文献类型:
--
作者:
Chang VW;Lauderdale DS

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尽管根本原因理论在健康差距研究文献的形成中具有很大的影响力,但该理论的实证研究很少,特别是在动态视角下。在这项研究中,我们研究了胆固醇水平的收入差距是如何随着他汀类药物(一种昂贵而有效的新药技术)的出现而改变的。使用1976年至2004年的全国代表性数据,我们发现胆固醇的收入梯度最初是正的,但在他汀类药物使用时代,收入梯度随后逆转并变为负的。虽然这些人以前更有可能有高水平的胆固醇,但现在他们的可能性降低了。我们认为我们的案例研究对一个更广泛的理论框架,概述了技术创新和健康差距之间的关系。我们发现,技术对社会经济差距的影响受到两个重要因素的影响:(1)技术变革的性质;(2)其扩散和采用的程度。
Although fundamental cause theory has been highly influential in shaping the research literature on health disparities, there have been few empirical demonstrations of the theory, particularly in dynamic perspective. In this study, we examine how income disparities in cholesterol levels have changed with the emergence of statins, an expensive and potent new drug technology. Using nationally representative data from 1976 to 2004, we find that income gradients for cholesterol were initially positive, but then reversed and became negative in the era of statin use. While the advantaged were previously more likely to have high levels of cholesterol, they are now less likely. We consider our case study against a broader theoretical framework outlining the relationship between technology innovation and health disparities. We find that the influence of technologies on socioeconomic disparities is subject to two important modifiers: (1) the nature of the technological change and (2) the extent of its diffusion and adoption.
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