Socioeconomic and Racial/Ethnic Disparities in the Incidence of Bacteremic Pneumonia Among US Adults
Socioeconomic and Racial/Ethnic Disparities in the Incidence of Bacteremic Pneumonia Among US Adults
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DOI：
10.2105/ajph.2009.181313
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发表时间：
2010-10-01
影响因子：
12.7
通讯作者：
Schuchat, Anne
中科院分区：
文献类型：
--
作者：
Burton, Deron C.;Flannery, Brendan;Schuchat, Anne
目标.我们研究了人口普查区域的社会经济特征与美国成年人中菌血症社区获得性肺炎发病率的种族/民族差异之间的关系。我们分析了4870名18岁或以上的社区获得性菌血症性肺炎成年人的数据，这些患者是通过在9个州进行主动的、基于人群的监测确定的，并按居住地进行了地理编码。我们使用2000年美国人口普查的数据，根据年龄、种族/民族和人口普查区特征计算发病率，并使用泊松回归估计率比（RR）和95%置信区间（Cls）。在2003年至2004年期间，菌血症性肺炎的平均年发病率为24.2例/10万黑人成人，而10.1例/10万白色成人（RR = 2.40; 95%CI = 2.24，2.57）。在贫困人口占20%或更多的人口普查区（最贫困），黑人居民的发病率是贫困人口占不到5%的人口普查区（最不贫困）的白色居民发病率的4.4倍。发病率的种族差异有所减少，但在控制年龄，人口普查区贫困水平和状态的模型中仍然显着。生活在贫困人口普查区的成年人患菌血症性肺炎的风险增加，应成为预防工作的目标。(Am J公共卫生。2010;100：1904-1911. doi：10.2105/AJPH.2009.181313）
Objectives. We examined associations between the socioeconomic characteristics of census tracts and racial/ethnic disparities in the incidence of bacteremic community-acquired pneumonia among US adults.Methods. We analyzed data on 4870 adults aged 18 years or older with community-acquired bacteremic pneumonia identified through active, population-based surveillance in 9 states and geocoded to census tract of residence. We used data from the 2000 US Census to calculate incidence by age, race/ethnicity, and census tract characteristics and Poisson regression to estimate rate ratios (RRs) and 95% confidence intervals (Cls).Results. During 2003 to 2004, the average annual incidence of bacteremic pneumonia was 24.2 episodes per 100000 Black adults versus 10.1 per 100000 White adults (RR = 2.40; 95% CI = 2.24, 2.57). Incidence among Black residents of census tracts with 20% or more of persons in poverty (most impoverished) was 4.4 times the incidence among White residents of census tracts with less than 5% of persons in poverty (least impoverished). Racial disparities in incidence were reduced but remained significant in models that controlled for age, census tract poverty level, and state.Conclusions. Adults living in impoverished census tracts are at increased risk of bacteremic pneumonia and should be targeted for prevention efforts. (Am J Public Health. 2010;100:1904-1911. doi:10.2105/AJPH.2009.181313)