A symmetrized Theil index measure of health disparities: An example using dental caries in U.S. children and adolescents
A symmetrized Theil index measure of health disparities: An example using dental caries in U.S. children and adolescents
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DOI：
10.1002/sim.4114
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发表时间：
2011-02-10
影响因子：
2
通讯作者：
Talih, Makram
中科院分区：
文献类型：
--
作者：
Borrell, Luisa N.;Talih, Makram
虽然美国人的健康状况随着时间的推移而普遍改善，但人口群体之间的健康差距一直很普遍。设计一种衡量办法来跟踪由此产生的差距仍然是一项挑战。本文提出了一种新的衡量健康差异的方法--对称泰尔指数（STI），并推导了其在分组调查数据中的抽样方差。由于性传播感染是对称的，它避免了泰尔指数在群体加权方面的缺陷：事实上，后者主要受到疾病频率高的群体的影响。此外，STI与二进制数据的独立性Pearson卡方检验和连续数据的单向方差分析中的F检验有关。我们说明了我们的方法使用的数据龋齿的儿童和青少年从第三次全国健康和营养检查调查（NHANES III; 1988-1994年）和NHANES 1999-2004年。蛀牙仍然是美国儿童和青少年最常见的慢性疾病。虽然他们的口腔健康状况总体上有所改善，但我们发现在两次调查之间，美国儿童和青少年未经治疗的蛀牙的患病率或严重程度没有变化。这些调查结果在总体性传播感染及其群体间组成部分的性别、种族/族裔、出生国、调查受访者的教育、收入和贫困收入比方面都得到了一致的观察。版权所有（C）2010约翰威利父子有限公司
While the health status of Americans has generally improved over time, health disparities among groups of the population have been pervasive. Designing a measure that tracks the resulting disparities remains a challenge. In this paper, we propose a new measure of health disparities the Symmetrized Theil Index (STI), and derive its design-based sampling variance in grouped survey data. Because STI is symmetric, it circumvents the drawback of the Theil Index in how groups are weighted: indeed, the latter is mostly influenced by groups with high disease frequencies. Moreover, STI is related to Pearson's chi-square test of independence for binary data, and to the F-test in one-way analysis-of-variance for continuous data. We illustrate our approach using data on dental caries for children and adolescents from the third National Health and Nutrition Examination Surveys (NHANES III; 1988-1994) and NHANES 1999-2004. Tooth decay remains the most common chronic disease in U.S. children and adolescents. Although their oral health has generally improved, we find no change in the prevalence or severity of untreated tooth decay in U.S. children and adolescents between surveys. These findings are consistently observed for both the overall STI and its between-group component across gender, race/ethnicity, country of birth, survey respondent's education, income and poverty income ratio. Copyright (C) 2010 John Wiley & Sons, Ltd.