Disparities in diabetes: the nexus of race, poverty, and place.
Disparities in diabetes: the nexus of race, poverty, and place.
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DOI：
10.2105/ajph.2013.301420
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发表时间：
2014-11
影响因子：
12.7
通讯作者：
Dubay L
中科院分区：
文献类型：
--
作者：
Gaskin DJ;Thorpe RJ Jr;McGinty EE;Bower K;Rohde C;Young JH;LaVeist TA;Dubay L
这项研究试图确定社区贫困和种族构成在糖尿病患病率中的种族差异方面的作用。使用1999-2004年全国健康和营养检查调查(NHANES)和2000年美国人口普查的数据，我们估计了个人种族和贫困以及邻里种族构成和贫困集中度对患糖尿病几率的影响。我们发现，黑人和贫穷白人的糖尿病患病率存在种族-贫困地区的梯度。与白人相比，黑人患糖尿病的几率更高。个人贫困增加了白人和黑人患糖尿病的几率。居住在贫困社区会增加黑人和贫穷白人患糖尿病的几率。为了解决糖尿病中的种族差异，政策制定者应该解决集中贫困造成的问题，例如，无法获得价格合理的水果和蔬菜、娱乐设施和医疗保健服务，以及高犯罪率和更多暴露在环境毒素中。城市地区的住房和发展政策应该避免形成高度贫困的社区。
This study seeks to determine the role of neighborhood poverty and racial composition on race disparities in diabetes prevalence. Using data from the 1999–2004 National Health and Nutrition Examination Survey (NHANES) and 2000 U.S. Census, we estimate the impact of individual race and poverty and neighborhood racial composition and poverty concentration on the odds of having diabetes. We found a race-poverty-place gradient for diabetes prevalence for blacks and poor whites. The odds of having diabetes was higher for blacks compared to whites. Individual poverty increased the odds of having diabetes for both whites and blacks. Living in a poor neighborhood increased the odds of having diabetes for blacks and poor whites. To address race disparities in diabetes, policymakers should address problems created by concentrated poverty, e.g., lack of access to reasonably priced fruits and vegetables, recreational facilities, and health care services, and high crime rates, and greater exposures to environmental toxins. Housing and development policies in urban areas should avoid creating high poverty neighborhoods.