Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: Does the choice of area-based measure and geographic level matter? The Public Health Disparities Geocoding Project
Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: Does the choice of area-based measure and geographic level matter? The Public Health Disparities Geocoding Project
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DOI：
10.1093/aje/kwf068
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发表时间：
2002-09-01
影响因子：
5
通讯作者：
Carson, R
中科院分区：
文献类型：
--
作者：
Krieger, N;Chen, JT;Carson, R
尽管地理编码以及使用基于区域的社会经济指标有望克服美国公共卫生监测系统中社会经济数据的匮乏，但对于应使用哪些指标以及在何种地理层面使用，尚未达成共识。作者在人口普查区、街区组和邮政编码层面为马萨诸塞州（1990年人口：6,016,425）和罗得岛州（1990年人口：1,003,464）生成了多种单变量和基于区域的综合社会经济指标，以研究它们与死亡率（1989 - 1991年：马萨诸塞州有156,366例居民死亡，罗得岛州有27,291例）以及原发性侵袭性癌症发病率（1988 - 1992年：马萨诸塞州有140,610例居民病例；1989 - 1992年：罗得岛州有19,808例居民病例）之间的关联。对全因和特定原因死亡率以及全因和特定部位癌症发病率的分析表明：1）街区组和普查区的社会经济指标在两个州内部以及两个州之间表现相当，但邮政编码层面的几种结果指标未检测到梯度，或者检测到的梯度与普查区和街区组指标所观察到的相反；2）通过五分位数和先验分类切点生成的类别检测到了相似的梯度；3）包含经济贫困数据的指标最为稳健，并且检测到了仅使用教育和财富指标未观察到的梯度。
Despite the promise of geocoding and use of area-based socioeconomic measures to overcome the paucity of socioeconomic data in US public health surveillance systems, no consensus exists as to which measures should be used or at which level of geography. The authors generated diverse single-variable and composite area-based socioeconomic measures at the census tract, block group, and zip code level for Massachusetts (1990 population: 6,016,425) and Rhode Island (1990 population: 1,003,464) to investigate their associations with mortality rates (1989-1991: 156,366 resident deaths in Massachusetts and 27,291 in Rhode Island) and incidence of primary invasive cancer (1988-1992: 140,610 resident cases in Massachusetts; 1989-1992: 19,808 resident cases in Rhode Island). Analyses of all-cause and cause-specific mortality rates and all-cause and site-specific cancer incidence rates indicated that: 1) block group and tract socioeconomic measures performed comparably within and across both states, but zip code measures for several outcomes detected no gradients or gradients contrary to those observed with tract and block group measures; 2) similar gradients were detected with categories generated by quintiles and by a priori categorical cutpoints; and 3) measures including data on economic poverty were most robust and detected gradients that were unobserved using measures of only education and wealth.