Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us
Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us
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DOI：
10.2105/ajph.2009.166082
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发表时间：
2010-01-01
影响因子：
12.7
通讯作者：
Pamuk, Elsie
中科院分区：
文献类型：
--
作者：
Braveman, Paula A.;Cubbin, Catherine;Pamuk, Elsie
目标。我们的目的是描述美国在多个健康指标和社会经济群体方面的社会经济差异。方法。利用最近关于 5 项儿童（婴儿死亡率、健康状况、活动限制、健康饮食、久坐青少年）和 6 项成人（预期寿命、健康状况、活动限制、心脏病、糖尿病、肥胖）健康指标的国家数据，我们检查了多个收入或教育类别的总体指标率和种族/族裔群体内的指标率。结果。收入最低和受教育程度最低的人始终健康状况最差，但就大多数指标而言，即使是中等收入和教育水平的群体也比最富有和受教育程度最高的人健康状况较差。梯度模式在非西班牙裔黑人和白人中常见，但在西班牙裔中则不太一致。结论。美国的健康状况往往（尽管并非总是如此）强烈地遵循社会经济和种族/族裔界限，这表明社会优势与健康的等级制度之间存在联系。社会最弱势群体的健康状况较差，因此需要优先考虑这些群体的政策，但普遍存在的梯度模式也表明需要解决更广泛的社会经济问题，这可能有助于获得政治支持。常规健康报告应联合和单独检查社会经济和种族/民族差异模式。 （美国公共卫生杂志。2010；100：S186-S196。doi：10.2105/AJPH.2009.166082）
Objectives. We aimed to describe socioeconomic disparities in the United States across multiple health indicators and socioeconomic groups.Methods. Using recent national data on 5 child (infant mortality, health status, activity limitation, healthy eating, sedentary adolescents) and 6 adult (life expectancy, health status, activity limitation, heart disease, diabetes, obesity) health indicators, we examined indicator rates across multiple income or education categories, overall and within racial/ethnic groups.Results. Those with the lowest income and who were least educated were consistently least healthy, but for most indicators, even groups with intermediate income and education levels were less healthy than the wealthiest and most educated. Gradient patterns were seen often among non-Hispanic Blacks and Whites but less consistently among Hispanics.Conclusions. Health in the United States is often, though not invariably, patterned strongly along both socioeconomic and racial/ethnic lines, suggesting links between hierarchies of social advantage and health. Worse health among the most socially disadvantaged argues for policies prioritizing those groups, but pervasive gradient patterns also indicate a need to address a wider socioeconomic spectrum-which may help garner political support. Routine health reporting should examine socioeconomic and racial/ethnic disparity patterns, jointly and separately. (Am J Public Health. 2010;100:S186-S196. doi:10.2105/AJPH.2009.166082)