Urban-rural differences in excess mortality among high-poverty populations: Evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health
Urban-rural differences in excess mortality among high-poverty populations: Evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health
复制标题
DOI：
10.1353/hpu.2006.0105
复制
发表时间：
2006-08-01
影响因子：
1.4
通讯作者：
James, Sherman A.
中科院分区：
文献类型：
--
作者：
Geronimus, Arline T.;Colen, Cynthia G.;James, Sherman A.
居住在高度贫困地区的黑人青年，如果他们是城市人，活到65岁的可能性比他们是农村人低得多。慢性病导致的死亡人数占了很大比例。我们开始使用哈莱姆家庭调查(HHS)和北卡罗来纳州皮特县非裔美国人健康研究(PCS)来探索原因。我们比较了HHS和PCS受访者在慢性病发病率、健康行为、社会支持、就业、医疗保健可获得性指标和医疗保险方面的差异。慢性病档案不利于皮特县。不同样本的吸烟率相似，但PCS受访者更有可能戒烟。在皮特县，获得医疗保健和私人健康保险的指标更为有利。研究结果表明，农村死亡可以通过二级或三级预防而不是一级预防来避免。过去20年的宏观经济和卫生系统的变化可能使贫穷的城市黑人在医疗上得不到足够的服务，就像贫穷的农村黑人一样。
Black youth residing in high-poverty areas have dramatically lower probabilities of surviving to age 65 if they are urban than if they are rural. Chronic disease deaths contribute heavily. We begin to probe the reasons using the Harlem Household Survey (HHS) and the Pitt County, North Carolina Study of African American Health (PCS). We compare HHS and PCS respondents on chronic disease rates, health behaviors, social support, employment, indicators of health care access, and health insurance. Chronic disease profiles do not favor Pitt County. Smoking uptake is similar across samples, but PCS respondents are more likely to quit. Indicators of access to health care and private health insurance are more favorable in Pitt County. Findings suggest rural mortality is averted through secondary or tertiary prevention, not primary. Macroeconomic and health system changes of the past 20 years may have left poor urban Blacks as medically underserved as poor rural Blacks.