Health Disparities Among Youth With Type 1 Diabetes: A Systematic Review of the Current Literature
Health Disparities Among Youth With Type 1 Diabetes: A Systematic Review of the Current Literature
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DOI：
10.1037/fsh0000134
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发表时间：
2015-09-01
影响因子：
1.3
通讯作者：
Everhart, Robin S.
中科院分区：
文献类型：
--
作者：
Borschuk, Adrienne P.;Everhart, Robin S.
简介：儿科 1 型糖尿病 (T1D) 的研究可靠地确定了基于种族/民族和社会经济地位 (SES) 的健康结果差异。少数种族/族裔和/或社会经济地位低的青年始终表现出比多数种族/族裔和社会经济地位高的青年更差的身体健康和心理功能。本综述的目的是更好地了解不同种族/民族和社会经济地位的 T1D 健康差异，并根据这些发现为研究人员提供建议。方法：文章取自 PsycINFO、PubMed 和 Web of Knowledge，搜索词为：“1 型糖尿病”、“种族”、“儿科”、“种族/民族”、“种族”、“社会经济地位”、“SES”和“收入”。纳入标准为 (a) 1 型糖尿病病例，(b) 儿童或青少年样本，(c) 按种族/民族或社会经济地位分组的健康或心理社会结果信息，(d) 无干预数据，(e) 同行评审，(f) 英语，以及 (g) 在学术期刊上发表。结果：27 篇文章报告了健康结果，4 篇文章报告了心理社会结果。在 16 项研究中，少数族裔青年的 HbA1c 水平高于白人青年。十八项研究报告称，社会经济地位较低的青少年的 HbA1c 水平高于社会经济地位较高的青少年。四项研究发现，少数族裔青年和社会经济地位较低的青年的心理功能比白人青年或社会经济地位较高的青年更差。讨论：我们的综述结果表明种族/族裔、SES 和儿科 T1D 健康结果之间存在关联。研究人员应考虑制定干预措施，考虑可能使少数种族/族裔和社会经济地位较低背景的儿童面临代谢控制和情绪功能不良风险的因素。未来的研究应该探讨健康差异的致病机制。
Introduction: Research in pediatric Type 1 diabetes (T1D) has reliably identified differences in health outcomes based on race/ethnicity and socioeconomic status (SES). Racial/ethnic minority and/or low-SES youth consistently display poorer physical health and psychological functioning than racial/ethnic majority and higher-SES youth. The purpose of this review is to better understand health disparities in T1D by race/ethnicity and SES, and to provide recommendations for researchers based on these findings. Methods: Articles were obtained from PsycINFO, PubMed, and Web of Knowledge with search terms: "Type 1 diabetes," "ethnic," "pediatric," "race/ethnicity," " race," "socioeconomic status," "SES," and "income." Criteria for inclusion were (a) Type 1 diabetes cases, (b) child or adolescent samples, (c) information about health or psychosocial outcomes grouped by race/ethnicity or SES, (d) no intervention data, (e) peer-reviewed, (f), English-language, and (g) published in an academic journal. Results: Twenty-seven articles reported on health outcomes and 4 articles reported on psychosocial outcomes. Across 16 studies, racial/ethnic minority youth displayed higher HbA1c levels compared to Caucasian youth. Eighteen studies reported that lower-SES youth had higher HbA1c levels than higher-SES youth. Four studies found racial/ethnic minority youth and lower-SES youth had poorer psychological functioning than Caucasian youth or higher-SES youth. Discussion: Findings from our review suggest an association between race/ethnicity, SES, and health outcomes in pediatric T1D. Researchers should consider developing interventions that take into account factors which may place children from racial/ethnic minority and lower-SES backgrounds at risk for poor metabolic control and emotional functioning. Future research should examine causative mechanisms of health disparities.