Methods and Software for Estimating Health Disparities: The Case of Children's Oral Health
Methods and Software for Estimating Health Disparities: The Case of Children's Oral Health
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DOI：
10.1093/aje/kwn207
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发表时间：
2008-10-15
影响因子：
5
通讯作者：
Gansky, Stuart A.
中科院分区：
文献类型：
--
作者：
Cheng, Nancy F.;Han, Pamela Z.;Gansky, Stuart A.
国家卫生统计中心最近发布了一本专著，其中有11项报告健康差异的指导方针。然而，置信区间（CI）的指导方针不能很容易地实施复杂的抽样调查往往用于疾病监测。在美国，龋齿是最常见的慢性儿童疾病，比哮喘常见5倍。少数种族/民族、移民和社会经济地位较低的人（SEP）的龋齿患病率更高。作者提供了将国家卫生统计中心指南应用于复杂样本调查的方法（健康差异指数以及评估种族/民族和SEP与CI健康结果相关性的绝对和相对差异测量）;说明了这些方法在儿童未经治疗的龋齿中的应用;提供了相关软件;并报告了模拟不同患病率的结果。他们使用来自2004-2005年加州儿童口腔健康需求评估的未治疗龋齿数据和学校参与免费/降价午餐计划的百分比来说明这些方法。绝对和相对的措施，不平等的斜率指数，不平等的相对指数（平均值和比率），和健康集中指数进行了估计。采用泰勒级数线性化和重新标度自助法估计CI。白色儿童和所有非白色儿童之间的口腔健康差异显着，并与SEP显着相关。
The National Center for Health Statistics recently issued a monograph with 11 guidelines for reporting health disparities. However, guidelines on confidence intervals (CIs) cannot be readily implemented with the complex sample surveys often used for disease surveillance. In the United States, dental caries (decay) is the most common chronic childhood disease-5 times more common than asthma. Racial/ethnic minorities, immigrants, and persons of lower socioeconomic position (SEP) have a greater prevalence of caries. The authors provide methods for applying National Center for Health Statistics guidelines to complex sample surveys (health disparity indices and absolute and relative difference measures assessing associations of race/ethnicity and SEP to health outcomes with CIs); illustrate the application of those methods to children's untreated caries; provide relevant software; and report results from a simulation varying prevalence. They use data on untreated caries from the California Oral Health Needs Assessment of Children 2004-2005 and school percentage of participation in free/reduced-price lunch programs to illustrate the methods. Absolute and relative measures, the Slope Index of Inequality, the Relative Index of Inequality (mean and ratio), and the Health Concentration Index were estimated. Taylor series linearization and rescaling bootstrap methods were used to estimate CIs. Oral health differed significantly between White children and all non-White children and was significantly related to SEP.