The formation of a socioeconomic health disparity: the case of cocaine use during the 1980s and 1990s.

The formation of a socioeconomic health disparity: the case of cocaine use during the 1980s and 1990s.
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DOI:
10.1177/002214650804900308
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发表时间:
2008-09
影响因子:
5
通讯作者:
Miech R
Miech R
中科院分区:
医学2区
文献类型:
--
作者:
Miech R

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尽管社会学对健康差距有很大和长期的兴趣,但对引发这些差距的过程仍然知之甚少。为了研究这一主题,我们重点研究了可卡因的使用,在1990年左右的短时间内,所有年龄段的人都出现了社会经济差异。我们考察了新形成的差异是否代表了以前用户的选择性剩余,或者相反,是选择性地招募了新用户。为了评估这两个潜在的过程,我们在一个具有全国代表性的队列中使用了潜在的类别回归,并对1990年前后的可卡因使用情况进行了重复测量。结果支持“残留”假设,并表明新形成的差异主要是因为较低社会阶层的人不太可能有可卡因的使用轨迹,1990年后可卡因的使用量急剧下降。这些结果表明,“残留物”概念是一种将非常不同和不同的健康结果的差异分析结合在一起的方法。
Despite the substantial and prolonged sociological interest in health disparities, much remains unknown about the processes that initiate them. To investigate this topic, we focus on the case study of cocaine use, for which a socioeconomic disparity emerged across all age groups in a short period of time around 1990. We examine whether the newly-formed disparity represents a selective remnant of previous users or, instead, a selective recruitment of new users. To evaluate these two potential processes we use latent class regression on a nationally representative cohort with repeated measures of past-year cocaine use before and after1990. Results support the “remnant” hypothesis and show that the newly-formed disparity resulted primarily because people in the lower social strata were less likely to have a trajectory of cocaine use with a sharp drop in use after 1990. These results point to the “remnant” concept as a way to bring together disparity analysis of very different and diverse health outcomes.
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