Variation in the magnitude of black-white differences in stroke mortality by community occupational structure.
Variation in the magnitude of black-white differences in stroke mortality by community occupational structure.
复制标题
不同社区职业结构中风死亡率的黑人和白人差异程度的变化。
DOI：
10.1136/jech.45.4.302
复制
发表时间：
1991
影响因子：
6.3
通讯作者：
Strogatz,D
中科院分区：
文献类型：
--
作者：
Casper,M;Wing,S;Strogatz,D
研究目的--目的是检查美国南部地区不同职业结构水平的社区中中风死亡率的黑人-白人差异模式。设计--计算1979-1981年与社会经济条件相关的中风死亡率的年年龄调整种族-性别特异性比率。环境--这项研究涉及美国南部地区的211个州的经济区。研究人群--居住在研究区域的35 - 74岁的黑人和白色男性和女性的中风死亡率数据来自国家卫生统计中心。测量和主要结果--职业结构被测量为每个州经济区中白色领工人的比例，是一个社区就业机会和相关社会经济资源的指标。分层分析和线性回归模型表明，职业结构较低的社区（a）所有四个种族性别组的卒中死亡率较高（p <0.05），（B）卒中死亡率的种族不平等较大（p <0.01）。对于男性和女性来说，在职业结构较低的社区，黑人的中风死亡率高于白人。结论--考虑职业结构和相关的经济发展模式对于了解种族群体内和种族群体之间的中风死亡率分布以及规划有效的公共卫生干预措施至关重要。南方职业结构较低的社区中更大的种族不平等表明，黑人经历中导致中风死亡率高的方面在这些社区中加剧了。减少中风死亡率的种族和社会不平等的公共卫生干预措施应认识到中风的营养，职业，医疗保健和环境决定因素分布的社会背景。
STUDY OBJECTIVE--The aim was to examine the patterns of black-white differences in stroke mortality across communities with varying levels of occupational structure in the southern region of the United States DESIGN--Annual age adjusted race-sex specific rates for stroke mortality were calculated for the years 1979-1981 and related to socioeconomic conditions. SETTING--The study involved 211 state economic areas comprising the southern region of the USA. STUDY POPULATION--Data on stroke mortality for black and white men and women between the ages of 35 and 74 years living in the study area were acquired from the National Center for Health Statistics. MEASUREMENTS AND MAIN RESULTS--Occupational structure was measured as the proportion of white collar workers in each state economic area, and is an indicator of the employment opportunities and related social and economic resources of a community. Stratified analyses and linear regression modelling indicate that communities of lower occupational structure have (a) higher levels of stroke mortality for all four race-sex groups (p less than 0.05) and (b) larger racial inequalities in stroke mortality (p less than 0.01). For men and women, the excess stroke mortality among blacks compared to whites is larger in communities of lower occupational structure. CONCLUSIONS--Consideration of occupational structure and related patterns of economic development is crucial for understanding the distribution of stroke mortality within and between racial groups, as well as for planning effective public health interventions. The larger racial inequalities in communities of lower occupational structure in the south suggest that aspects of the black experience which are conducive to high rates of stroke mortality are exacerbated in those communities. Public health interventions to reduce the racial and social inequalities in stroke mortality should recognise the social context within which nutritional, occupational, medical care, and environmental determinants of stroke are distributed.