California Healthy Places Index: Frames Matter
California Healthy Places Index: Frames Matter
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DOI：
10.1177/0033354919849882
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发表时间：
2019-07-01
影响因子：
3.3
通讯作者：
Snellings, Lauren
中科院分区：
文献类型：
--
作者：
Maizlish, Neil;Delaney, Tracy;Snellings, Lauren
简介：我们描述了加州健康场所指数（HPI）及其相对于其他指数在人口普查区水平上衡量社区福祉的表现。卫生部门和社区组织确定需要一种植根于健康的社会决定因素的指数，以供基于地方的政策制定和规划确定。该指数在地理上是精细的，根据出生时的预期寿命进行验证，并与政策行动相关联。材料和方法：在文献、公共卫生专家和积极资产框架的指导下，我们根据与健康相关的地方因素的公开人口普查区数据，开发了加利福尼亚州社区福祉的综合指数。25个HPI指标跨越8个领域；使用加权分位数和方法，从它们与区域水平预期寿命的经验关联中得出权重。结果：健康指数的域与经济资源、教育、住房、交通、清洁环境、邻里条件、社会资源和卫生保健可及性等健康的社会决定因素和政策行动领域相一致。总体HPI得分是加权领域得分的总和，其中经济和教育的影响很大（占总权重的50%）。HPI与出生时预期寿命密切相关（r = 0.58）。与HPI相比，以污染为导向的指数并没有涵盖人口普查区中最弱势的四分之一（代表300万加州人）的三分之一。在人口普查区中，HPI最弱势的四分之一在经济剥夺指数上的重叠程度更大。我们将HPI百分位数排名可视化为一个基于网络的地图工具，该工具展示了多个地区的HPI，并将指标与面向行动的政策指南联系起来。
Introduction: We describe the California Healthy Places Index (HPI) and its performance relative to other indexes for measuring community well-being at the census-tract level. The HPI arose from a need identified by health departments and community organizations for an index rooted in the social determinants of health for place-based policy making and program targeting. The index was geographically granular, validated against life expectancy at birth, and linked to policy actions. Materials and Methods: Guided by literature, public health experts, and a positive asset frame, we developed a composite index of community well-being for California from publicly available census-tract data on place-based factors linked to health. The 25 HPI indicators spanned 8 domains; weights were derived from their empirical association with tract-level life expectancy using weighted quantile sums methods. Results: The HPI's domains were aligned with the social determinants of health and policy action areas of economic resources, education, housing, transportation, clean environment, neighborhood conditions, social resources, and health care access. The overall HPI score was the sum of weighted domain scores, of which economy and education were highly influential (50% of total weights). The HPI was strongly associated with life expectancy at birth (r = 0.58). Compared with the HPI, a pollution-oriented index did not capture one-third of the most disadvantaged quartile of census tracts (representing 3 million Californians). Overlap of the HPI's most disadvantaged quartile of census tracts was greater for indexes of economic deprivation. We visualized the HPI percentile ranking as a web-based mapping tool that presented the HPI at multiple geographies and that linked indicators to an action-oriented policy guide.