Socioeconomic status and end-stage renal disease in the United States.
Socioeconomic status and end-stage renal disease in the United States.
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美国的社会经济状况和终末期肾病。
DOI：
10.1038/ki.1994.120
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发表时间：
1994
影响因子：
19.6
通讯作者：
Wolfe,RA
中科院分区：
文献类型：
--
作者：
Young,EW;Mauger,EA;Jiang,KH;Port,FK;Wolfe,RA
美国的社会经济地位和终末期肾病。经治疗的终末期肾病(ESRD)的发病率因年龄、种族、性别和人口的地理特征而显著不同。我们询问，接受治疗的终末期肾病(t-ESRD)发病率的某些变异性是否与社会经济地位的差异有关，以及社会经济地位是否可以解释种族对t-ESRD发病率的一些影响。1983年至1988年发生的t-ESRD病例的人口统计学特征从美国肾脏数据系统获得，该系统登记了最多治疗的ESRD病例。居住地县的平均种族特定人均收入，由卫生专业人员地区资源档案确定，被用作社会经济地位的替代衡量标准。60岁以上人群的t-ESRD发病率被模拟为社会经济和人口因素的对数线性函数，包括年龄、性别、居住县的城市比例和人口普查地理区域。正如预期的那样，无论是白人还是黑人，t-ESRD在男性和老年人群中的发病率都更高。总体而言，t-ESRD的发病率与收入水平呈负相关。对于白人来说，收入在0到10,000美元之间的相对风险是1.21，10,000到15,000美元的相对风险是1.11，15,000美元到20,000美元的相对风险是1.00，20,000美元到25,000美元的相对风险是0.89，收入和>25,000美元的相对风险是0.77。对于黑人来说，收入在0到10,000美元之间的相对风险是1.10，10,000到15,000美元的相对风险是1.20，15,000美元到20,000美元的相对风险是1.00，20,000美元到25,000美元的相对风险是0.81，收入&>25,000美元的相对风险是0.69。在最低收入水平，t-ESRD的发病率低于黑人的线性模型预测。T-ESRD在黑人中的高绝对发病率只能部分解释较低的社会经济地位。T-ESRD的发病率在人均收入水平范围内的差异约为40%至50%，但县平均收入并不能完全解释种族、性别或年龄的影响。
Socioeconomic status and end-stage renal disease in the United States. The incidence of treated end-stage renal disease (ESRD) varies markedly according to age, race, sex, and geographic characteristics of the population. We asked whether some of the variability in the incidence of treated ESRD (t-ESRD) was associated with differences in socioeconomic status and whether socioeconomic status could explain some of the effects of race on t-ESRD incidence. Demographic characteristics of incident cases of t-ESRD from the years 1983 to 1988 were obtained from the U.S. Renal Data System, which registers most treated cases of ESRD. The average race specific, per capita income of the county of residence, as determined from the Bureau of Health Professions Area Resource File, was used as a surrogate measure of socioeconomic status. The incidence of t-ESRD for individuals <60 years of age was modeled as a log-linear function of socioeconomic and demographic factors, including age, sex, the urban fraction of the county of residence, and the census geographic region. For both Whites and Blacks, the incidence of t-ESRD was higher for males and older age groups, as expected. In general, the incidence of t-ESRD was inversely related to income level. For Whites, the relative risk was 1.21 for income of $0 to 10,000, 1.11 for $10,000 to 15,000, 1.00 for $15,000 to 20,000 (reference), 0.89 for $20,000 to 25,000, and 0.77 for income > $25,000. For Blacks, the relative risk was 1.10 for income of $0 to 10,000, 1.20 for $10,000 to 15,000, 1.00 for $15,000 to 20,000 (reference), 0.81 for $20,000 to 25,000, and 0.69 for income > $25,000. At the lowest income level, the incidence of t-ESRD was lower than would be projected by a linear model for Blacks. The high absolute incidence of t-ESRD among Blacks was only partially explained by lower socioeconomic status. The incidence of t-ESRD varies by approximately 40 to 50% over the range of average per capita income levels but average county income does not fully explain the effects of race, sex, or age.