Zip code-level risk factors for tuberculosis: Neighborhood environment and residential segregation in New Jersey, 1985-1992
Zip code-level risk factors for tuberculosis: Neighborhood environment and residential segregation in New Jersey, 1985-1992
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DOI：
10.2105/ajph.91.5.734
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发表时间：
2001-05-01
影响因子：
12.7
通讯作者：
Acevedo-Garcia, D
中科院分区：
文献类型：
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作者：
Acevedo-Garcia, D
目标.本研究调查了1985-1992年新泽西非西班牙裔白人、非裔美国人、西班牙裔和亚洲人中与极高结核病（TB）发病率相关的邮政编码水平的危险因素。暴露指数（贫穷、拥挤的住房）。和破旧的住房）和隔离指数（与移民接触，隔离和密度）被用来描述邮政编码。一个布尔逻辑方法被用来确定哪些配置的风险因素显着区分邮政编码的结核病发病率非常高，从其他邮政编码。对于白人和亚洲人来说，在结核病发病率非常高的邮政编码中，风险因素很少。这与按年龄和外国出生身份分列的结核病病例分布情况一致，表明白人病例可能是由再活化引起的，而亚洲人病例可能是输入性的。相反，西班牙裔和非洲裔美国人暴露于可能促进结核病传播的危险因素，在西班牙裔中，与移民的高接触是一个重要因素。非裔美国人是最经常暴露于多种危险因素的群体。对于西班牙裔和非洲裔美国人，邮政编码水平的风险因素与非常高的结核病发病率相关。
Objectives. This study examined zip code-level risk factors associated with very high tuberculosis (TB) rates among non-Hispanic Whites, African Americans, Hispanics, and Asians in New Jersey(1985-1992).Methods. Exposure indices (poverty, crowded housing. and dilapidated housing) and segregation indices (contact with immigrants, isolation, and density) were used to characterize zip codes. A Boolean-logic methodology was used to determine which configurations of risk factors significantly distinguish zip codes where TB rates are very high from other zip codes.Results. For Whites and Asians, risk factors were rare in zip codes with very high TB rates. In agreement with the distribution of TB cases by age and foreign-born status, this,suggests that cases among Whites may be caused by reactivation,whereas cases among Asians may be imported. In contrast, Hispanics and African Americans were exposed to risk factors that may facilitate TB transmission, Among Hispanics, high contact with immigrants was an important factor. African Americans were the group most frequently exposed to multiple risk factors.Conclusions. For Hispanics and African Americans, zip code-level risk factors were associated with very high TB rates.