Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: why we should measure them all.
Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: why we should measure them all.
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DOI：
10.1186/1475-9276-13-47
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发表时间：
2014-06-13
影响因子：
4.8
通讯作者：
Rudolph B
中科院分区：
文献类型：
--
作者：
Asada Y;Whipp A;Kindig D;Billard B;Rudolph B
定期报告健康不平等现象对于监测减少健康不平等现象的努力进展至关重要。虽然报告人口健康状况的做法越来越普遍，但按人口健康的每项指标报告一个人口分组的情况却很少成为标准做法。这项研究报告了教育，性别和种族相关的不平等，在四个健康结果在每个选定的93个县在美国以系统和可比的方式。这项研究是一个大型的横截面分析，公开数据，2008年，2009年和2010年行为风险因素监测系统（BRFSS）选择大都市/小都市区风险趋势（SMART）和2008年，2009年和2010年美国出生记录从国家生命统计系统。研究人群是居住在选定的93个县的25岁以上的美国成年人，约占美国人口的30%，大致相等地覆盖了美国的所有地理区域。主要结果指标为：（1）属性（群体特征）特定的不平等：四种健康结果中每一种的教育、性别或种族特定的不平等（2）总体不平等：每个县每种健康结果的这三个属性特定不平等的平均值;（3）总发病率的总体不平等：每个县四种健康结果总体不平等的加权平均数。各州的不平等程度因健康结果而有很大差异;在所有健康结果的不平等中，健康状况差或健康状况一般的不平等程度最大，中位数最高。在超过70%的县，教育方面的不平等是所有健康结果中最大的，除了低出生体重。可以扩大人口健康报告的范围，利用公开数据，在一个小的管辖范围内报告人口健康每项指标的亚人口组分类情况。没有任何一个群体的特征或健康结果能够代表人口健康不平等的全貌。以可比方式审查多个群体的特征和结果对于报告健康不平等现象至关重要。
Regular reporting of health inequalities is essential to monitoring progress of efforts to reduce health inequalities. While reporting of population health became increasingly common, reporting of a subpopulation group breakdown of each indicator of the health of the population is rarely a standard practice. This study reports education-, sex-, and race-related inequalities in four health outcomes in each of the selected 93 counties in the United States in a systematic and comparable manner. This study is a cross-sectional analysis of large, publicly available data, 2008, 2009, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan/Micropolitan Area Risk Trends (SMART) and 2008, 2009, and 2010 United States Birth Records from the National Vital Statistics System. The study population is American adults older than 25 years of age residing in the selected 93 counties, representing about 30% of the US population, roughly equally covering all geographic regions of the country. Main outcome measures are: (1) Attribute (group characteristic)-specific inequality: education-, sex-, or race-specific inequality in each of the four health outcomes (poor or fair health, poor physical health days, poor mental health days, and low birthweight) in each county; (2) Overall inequality: the average of these three attribute-specific inequalities for each health outcome in each county; and (3) Summary inequality in total morbidity: the weighted average of the overall inequalities across the four health outcomes in each county. The range of inequality across the counties differed considerably by health outcome; inequality in poor or fair health had the widest range and the highest median among inequalities in all health outcomes. In more than 70% of the counties, education-specific inequality was the largest in all health outcomes except for low birthweight. It is feasible to extend population health reporting to include reporting of a subpopulation group breakdown of each indicator of the health of the population at a small jurisdictional level using publicly available data. No single group characteristic or health outcome represents the whole picture of health inequalities in a population. Examining multiple group characteristics and outcomes in a comparable manner is essential in reporting health inequalities.
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影响因子：
12.7
作者：
Kindig, D;Stoddart, G
通讯作者：
Stoddart, G
影响因子：
168.9
作者：
Murray, Christopher J. L.;Vos, Theo;Lopez, Alan D.
通讯作者：
Lopez, Alan D.
影响因子：
0.9
作者：
Gastwirth, Joseph L.
通讯作者：
Gastwirth, Joseph L.
影响因子：
1.2
作者：
Decancq, Koen;Lugo, Maria Ana
通讯作者：
Lugo, Maria Ana
DOI：
10.1111/milq.12001
发表时间：
2013-03
期刊：
The Milbank quarterly
影响因子：
--
作者：
Asada Y;Yoshida Y;Whipp AM
通讯作者：
Whipp AM