Methodological Approaches to Understanding Causes of Health Disparities
Methodological Approaches to Understanding Causes of Health Disparities
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DOI：
10.2105/ajph.2018.304843
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发表时间：
2019-01-01
影响因子：
12.7
通讯作者：
Breen, Nancy
中科院分区：
文献类型：
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作者：
Jeffries, Neal;Zaslavsky, Alan M.;Breen, Nancy
了解健康差距的原因是制定消除差距的政策或干预措施的重要第一步，但其性质使确定和解决其原因具有挑战性。潜在的原因因素往往是相关的，因此很难区分它们的影响。这些因素可能存在于不同的组织层面(例如，个人、家庭、社区)，每个因素都需要适当地概念化和衡量。产生健康差异的过程可能包括与反馈环和动态特性的复杂关系，这是传统统计模型表现得很差的。由于这种复杂性，识别差异的原因和补救措施需要整合多种方法的研究结果。我们强调分析方法和设计、多层次方法、复杂系统建模技术和定性方法，这些方法应该得到更广泛的应用和调整，以推进健康差距研究并确定缓解这些差距的方法。
Understanding health disparity causes is an important first step toward developing policies or interventions to eliminate disparities, but their nature makes identifying and addressing their causes challenging.Potential causal factors are often correlated, making it difficult to distinguish their effects. These factors may exist at different organizational levels (e.g., individual, family, neighborhood), each of which needs to be appropriately conceptualized and measured. The processes that generate health disparities may include complex relationships with feedback loops and dynamic properties that traditional statistical models represent poorly.Because of this complexity, identifying disparities' causes and remedies requires integrating findings from multiple methodologies. We highlight analytic methods and designs, multilevel approaches, complex systems modeling techniques, and qualitative methods that should be more broadly employed and adapted to advance health disparities research and identify approaches to mitigate them.