Exploring racial disparities in CHD mortality between blacks and whites across the United States: a geographically weighted regression approach.
Exploring racial disparities in CHD mortality between blacks and whites across the United States: a geographically weighted regression approach.
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DOI：
10.1016/j.healthplace.2012.06.006
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发表时间：
2012-09
期刊：
影响因子：
4.8
通讯作者：
Diez Roux AV
中科院分区：
文献类型：
--
作者：
Gebreab SY;Diez Roux AV
冠心病（CHD）死亡率是美国（US）种族健康差异的主要原因之一。我们研究了美国黑人和白人冠心病死亡率差异的空间异质性，并评估了贫困和种族隔离的贡献。我们使用了1996年至2006年美国大陆黑人和白人的县一级经年龄调整的CHD死亡率。采用地理加权回归评估空间异质性。在控制贫困和隔离之前，冠心病死亡率的黑人-白人差异存在显著的空间异质性（中位数黑人-白人差异为17.7/10万，第25 - 75百分位数（IQR）：4.0，34.0，空间非平稳性P值< 0.0001）。在考虑了特定种族贫困和隔离的县差异以及这些变量与种族的相互作用后，这种异质性不再存在（黑人-白人差异中位数为-13.5/100，000，IQR：-41.3，15.7，空间非平稳性P值= 0.4346）。研究结果表明，空间异质性在理解和消除冠心病死亡率种族差异方面的重要性。需要进行更多的研究，以确定解释种族差异的地方差异的个人和背景因素。
Coronary heart disease (CHD) mortality is one of the major contributors to racial disparities in health in the United States (US). We examined spatial heterogeneity in black–white differences in CHD mortality across the US and assessed the contributions of poverty and segregation. We used county-level, age-adjusted CHD mortality rates for blacks and whites in the continental US between 1996 and 2006. Geographically weighted regression was employed to assess spatial heterogeneity. There was significant spatial heterogeneity in black–white differences in CHD mortality (median black–white difference 17.7 per 100,000, 25th–75th percentile (IQR): 4.0, 34.0, P value for spatial non-stationarity < 0.0001) before controlling for poverty and segregation. This heterogeneity was no longer present after accounting for county differences in race-specific poverty and segregation and interactions of these variables with race (median black–white difference −13.5 per 100,000, IQR: −41.3, 15.7, P value for spatial non-stationarity = 0.4346). The results demonstrate the importance of spatial heterogeneity in understanding and eliminating racial disparities in CHD mortality. Additional research to identify the individual and contextual factors that explain the local variations in racial disparities is warranted.
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