Socio-economic disparities in the burden of seasonal influenza: the effect of social and material deprivation on rates of influenza infection.
Socio-economic disparities in the burden of seasonal influenza: the effect of social and material deprivation on rates of influenza infection.
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DOI：
10.1371/journal.pone.0017207
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发表时间：
2011-02-17
期刊：
影响因子：
3.7
通讯作者：
Buckeridge DL
中科院分区：
文献类型：
--
作者：
Charland KM;Brownstein JS;Verma A;Brien S;Buckeridge DL
几乎没有经验证据支持流感感染率与物质剥夺程度（即无法获得商品和服务）和社会剥夺程度（即缺乏社会凝聚力和支持）之间的关系。利用1996年至2006年经验证的人口水平物质和社会剥夺指数以及门诊和急诊流感就诊的医疗账单索赔，我们使用贝叶斯生态回归模型评估了社区流感发病率与社区剥夺水平之间的关系。然后，通过汇集来自前十分之一（即最贫困）和后十分之一社区的数据，我们使用年龄和性别标准化比率比较了最贫困人口和最贫困人口的比率。剥夺得分从1到5分不等，5分代表剥夺程度最高。我们发现，社会剥夺评分每增加1个单位，比率就会降低21%（比率比[RR] 0.79, 95%可信区间[CrI] 0.66, 0.97）。几乎没有证据表明与物质剥夺有意义的线性关系（RR 1.06, 95% CrI 0.93, 1.24）。然而，相对于贫困分数处于最低十分之一的社区，处于最高十分之一的社区（即物质上最贫困的社区）的犯罪率要高得多（相对危险度2.02,95%可信区间1.99,2.05）。虽然假设社会和物质剥夺会增加急性呼吸道感染的风险，但我们发现随着社会剥夺的增加，流感的医疗保健使用率会下降。这一发现可能是由于社会接触较少，因此社会剥夺者接触流感的机会较少。虽然没有证据表明与物质匮乏有线性关系，但当比较物质匮乏程度最低的人群和物质匮乏程度最高的人群时，我们观察到物质匮乏程度最高的人群的肥胖率更高。
There is little empirical evidence in support of a relationship between rates of influenza infection and level of material deprivation (i.e., lack of access to goods and services) and social deprivation (i.e. lack of social cohesion and support). Using validated population-level indices of material and social deprivation and medical billing claims for outpatient clinic and emergency department visits for influenza from 1996 to 2006, we assessed the relationship between neighbourhood rates of influenza and neighbourhood levels of deprivation using Bayesian ecological regression models. Then, by pooling data from neighbourhoods in the top decile (i.e., most deprived) and the bottom decile, we compared rates in the most deprived populations to the least deprived populations using age- and sex-standardized rate ratios. Deprivation scores ranged from one to five with five representing the highest level of deprivation. We found a 21% reduction in rates for every 1 unit increase in social deprivation score (rate ratio [RR] 0.79, 95% Credible Interval [CrI] 0.66, 0.97). There was little evidence of a meaningful linear relationship with material deprivation (RR 1.06, 95% CrI 0.93, 1.24). However, relative to neighbourhoods with deprivation scores in the bottom decile, those in the top decile (i.e., most materially deprived) had substantially higher rates (RR 2.02, 95% Confidence Interval 1.99, 2.05). Though it is hypothesized that social and material deprivation increase risk of acute respiratory infection, we found decreasing healthcare utilization rates for influenza with increasing social deprivation. This finding may be explained by the fewer social contacts and, thus, fewer influenza exposure opportunities of the socially deprived. Though there was no evidence of a linear relationship with material deprivation, when comparing the least to the most materially deprived populations, we observed higher rates in the most materially deprived populations.
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影响因子：
158.5
作者：
Reichert, TA;Sugaya, N;Tashiro, M
通讯作者：
Tashiro, M
影响因子：
5
作者：
Brownstein, JS;Kleinman, KP;Mandl, KD
通讯作者：
Mandl, KD
影响因子：
5.4
作者：
Crighton, Eric J.;Elliott, Susan J.;Upshur, Ross
通讯作者：
Upshur, Ross
DOI：
10.1196/annals.1425.035
发表时间：
2008-01-01
期刊：
REDUCING THE IMPACT OF POVERTY ON HEALTH AND HUMAN DEVELOPMENT: SCIENTIFIC APPROACHES
影响因子：
--
作者：
Kaler, Stephen G.
通讯作者：
Kaler, Stephen G.
影响因子：
4.3
作者：
Jordan, Rachel;Verlander, Neville;Hawker, Jeremy I.
通讯作者：
Hawker, Jeremy I.