OVERCOMING THE ABSENCE OF SOCIOECONOMIC DATA IN MEDICAL RECORDS - VALIDATION AND APPLICATION OF A CENSUS-BASED METHODOLOGY
OVERCOMING THE ABSENCE OF SOCIOECONOMIC DATA IN MEDICAL RECORDS - VALIDATION AND APPLICATION OF A CENSUS-BASED METHODOLOGY
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DOI：
10.2105/ajph.82.5.703
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发表时间：
1992-05-01
影响因子：
12.7
通讯作者：
KRIEGER, N
中科院分区：
文献类型：
--
作者：
KRIEGER, N
背景 大多数美国医疗记录缺乏社会经济数据，阻碍了对健康社会梯度的研究，以及确定研究样本是否代表一般人群。 本研究评估了有效性的人口普查为基础的方法，在解决这些问题。 1980年人口普查区和街区组的社会经济数据与1985年大型预付医疗计划（n = 190万）的会员记录相匹配，每个人的居住地址提供了链接。 在14420名黑人和白色成员的子集中，比较了个体、人口普查区域和人口普查区块组社会经济指标与高血压、身高、吸烟和生殖史的关系。 人口普查水平和个人水平的社会经济指标与选定的健康结果相似。 人口普查数据允许评估响应偏差，由于缺少个人层面的社会经济数据，也涉及个人和社区层面的社会经济特征的相互作用的背景效应。 根据区块组的特征，健康计划成员一般是代表总人口;人在贫困社区，但是，代表性不足。 这种基于普查的方法提供了一种有效和有用的方法来克服大多数美国医疗记录中缺乏社会经济数据的问题。
Background. Most US medical records lack socioeconomic data, hindering studies of social gradients in health and ascertainment of whether study samples are representative of the general population. This study assessed the validity of a census-based approach in addressing these problems.Methods. Socioeconomic data from 1980 census tracts and block groups were matched to the 1985 membership records of a large prepaid health plan (n = 1.9 million), with the link provided by each individual's residential address. Among a subset of 14 420 Black and White members, comparisons were made of the association of individual, census tract, and census block-group socioeconomic measures with hypertension, height, smoking, and reproductive history.Results. Census-level and individual-level socioeconomic measures were similarly associated with the selected health outcomes. Census data permitted assessing response bias due to missing individual-level socioeconomic data and also contextual effects involving the interaction of individual- and neighborhood-level socioeconomic traits. On the basis of block-group characteristics, health plan members generally were representative of the total population; persons in impoverished neighborhoods, however, were underrepresented.Conclusions. This census-based methodology offers a valid and useful approach to overcoming the absence of socioeconomic data in most US medical records.