Demographic Correlates of Veterans' Adverse Social Determinants of Health
Demographic Correlates of Veterans' Adverse Social Determinants of Health
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DOI：
10.1016/j.amepre.2020.05.024
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发表时间：
2020-12-01
影响因子：
5.5
通讯作者：
Blosnich, John R.
中科院分区：
文献类型：
--
作者：
Montgomery, Ann Elizabeth;Tsai, Jack;Blosnich, John R.
简介：确定受不良社会健康决定因素影响最大的患者人群可以指导流行病学调查，指导定制干预措施的开发，并改善临床护理和结果。本研究探讨了人口统计学特征如何与特定类型和累积负担相关联的健康不良社会决定因素退伍军人之间寻求退伍军人健康管理局health care.Methods：数据包括电子健康记录为293，872退伍军人健康管理设施在一个地区的国家10月1日和2015年9月30日之间。在2019年8月至12月期间进行的一系列多重logistic回归分析研究了人口统计学变量如何与健康的7个不利社会决定因素相关联。负二项回归研究的人口特征和累积负担的社会决定因素的health.Results：人口特征之间的关联与每种类型的不利健康的社会决定因素的几率增加：少数民族，未婚状态，退伍军人的服务连接残疾状态。相反，生活在农村地区并且年龄>40岁与这里研究的大多数不利的健康社会决定因素的几率降低有关。西班牙裔和女性性别与一些不利的健康社会决定因素的几率增加和其他因素的几率降低不一致。这些结果反映在预测因素的累积负担的不利的社会决定因素的health.Conclusions：有越来越多的和持续的兴趣的方式来识别和应对患者的经验或暴露于不利的社会决定因素的健康。人口特征可能表明需要评估健康的不利社会决定因素。分析探讨这些社会决定因素中的潜在因素（例如，贫困）可为确定面临不利健康社会决定因素的患者并提供相应干预措施的战略提供信息。爱思唯尔公司出版《美国预防医学杂志》（American Journal of Preventive Medicine）
Introduction: Identifying patient populations most affected by adverse social determinants of health can direct epidemiologic investigation, guide development of tailored interventions, and improve clinical care and outcomes. This study explores how demographic characteristics are asso-ciated with specific types-and cumulative burden-of adverse social determinants of health among Veterans seeking Veterans Health Administration health care.Methods: Data included electronic health records for 293,872 patients of Veterans Health Administration facilities in one region of the country between October 1, 2015 and September 30, 2016. A series of multiple logistic regressions conducted between August and December 2019 examined how demographic variables are associated with 7 adverse social determinants of health. A negative binomial regression examined the association between demographic characteristics and cumulative burden of social determinants of health.Results: Demographic characteristics were associated with increased odds of each type of adverse social determinant of health: minority race, unmarried status, and Veterans' service connected disability status. Conversely, living in a rural area and being aged >40 years were associated with decreased odds of most of the adverse social determinants of health studied here. Hispanic ethnicity and female sex were inconsistently associated with increased odds of some adverse social determinants of health and decreased odds of others. These results are mirrored in the analysis of predictors of cumulative burden of adverse social determinants of health.Conclusions: There is increasing and ongoing interest in ways to identify and respond to patients' experiences of or exposures to adverse social determinants of health. Demographic characteristics may signal the need to assess for adverse social determinants of health. Analyses exploring latent factors among these social determinants (e.g., poverty) may inform strategies to identify patients experiencing adverse social determinants of health and provide responsive interventions. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.