• 【参加WIC的美国儿童在饮食摄入方面的种族/种族差异。】 复制标题 收藏 收藏
    DOI:10.3390/nu11112607 复制DOI
    作者列表:Zimmer MC,Rubio V,Kintziger KW,Barroso C
    BACKGROUND & AIMS: :Recent studies have assessed diet quality of low-income U.S. children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but differences by race/ethnicity remain unknown. We assessed racial/ethnic disparities in nutrient intake from dietary sources (not supplements) among children participating in WIC, with a focus on priority nutrients and food groups for future WIC food package revisions, as described in a recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM). We used data from the 2011-2014 National Health and Nutrition Examination Surveys (NHANES) and multivariable linear regression analysis to evaluate relationships between race/ethnicity and nutrient/food group intake of children participating in WIC. All data were analyzed using SAS 9.4 survey procedures, accounting for the complex survey design of the NHANES. Compared to non-Hispanic White children, Hispanic children had diets with better nutrient distribution and lower dietary energy density, while non-Hispanic Black children had diets with poorer nutrient intake. Hispanic children had higher potassium and fiber intake, and consumed more legumes, while non-Hispanic Black children had lower calcium and vitamin D intake, higher sodium intake, and lower total dairy intake, compared to non-Hispanic White children. These findings can inform WIC nutrition education messages and future food package revisions.
    背景与目标: :最近的研究评估了参加妇女,婴儿和儿童特别营养补充计划(WIC)的美国低收入儿童的饮食质量,但种族/族裔之间的差异仍然未知。正如美国国家科学院最近的报告所述,我们评估了参加WIC的儿童从饮食来源(而非补充剂)中摄入的营养素的种族/种族差异,重点关注了未来WIC食品包装修订中的优先营养素和食物组。 ,工程与医学(NASEM)。我们使用了2011-2014年全国健康和营养检查调查(NHANES)的数据以及多变量线性回归分析来评估参加WIC的儿童的种族/族裔与营养/食物组摄入量之间的关系。所有数据均使用SAS 9.4调查程序进行了分析,这说明了NHANES的复杂调查设计。与非西班牙裔白人儿童相比,西班牙裔儿童的饮食具有更好的营养分布和较低的饮食能量密度,而非西班牙裔黑人儿童的饮食具有较低的营养摄入量。与非西班牙裔白人儿童相比,西班牙裔儿童的钾和纤维摄入量较高,并且食用豆类较多,而非西班牙裔黑人儿童的钙和维生素D摄入量较低,钠摄入量较高,乳制品总摄入量较低。这些发现可以为WIC营养教育信息和将来的食品包装修订提供参考。
  • 【测量性传播疾病发病率的差异。】 复制标题 收藏 收藏
    DOI:10.1097/OLQ.0b013e3181886750 复制DOI
    作者列表:Hoover K,Bohm M,Keppel K
    BACKGROUND & AIMS: :The Centers for Disease Control and Prevention (CDC) defines a health disparity as a "[health] difference that occurs by gender, race or ethnicity, education or income, disability, geographic location, or sexual orientation." Health equity is achieved by eliminating health disparities or inequalities. Measuring health disparities is a critical first step toward reducing differences in health outcomes. To determine the methods to be used in measuring a health disparity, several decisions must be made, which include: (1) selecting a reference group for the comparison of 2 or more groups; (2) determining whether a disparity should be measured in absolute or in relative terms; (3) opting to measure health outcomes or health indicators expressed as adverse or favorable events; (4) selecting a method to monitor a disparity over time; and (5) choosing to measure a disparity as a pair-wise comparison between 2 groups or in terms of a summary measure of disparity among all groups for a particular characteristic. Different choices may lead to different conclusions about the size and direction of health disparities at a point in time and changes in disparities over time.The objective of this article is to review the methods for measuring health disparities, provide examples of their use, and make specific recommendations for measuring disparities in the incidence of sexually transmitted diseases (STDs).
    背景与目标: :疾病控制与预防中心(CDC)将健康差异定义为“ [性别],性别,种族或族裔,教育或收入,残疾,地理位置或性取向引起的[健康]差异”。通过消除健康差距或不平等来实现健康公平。衡量健康差距是减少健康结果差异的关键的第一步。为了确定用于测量健康差异的方法,必须做出几项决定,其中包括:(1)选择一个参考组以比较两个或更多组。 (2)确定应以绝对还是相对来衡量差异; (3)选择测量以不良或有利事件表示的健康结果或健康指标; (4)选择一种方法来监控随时间的差异; (5)选择测量差异作为两个组之间的成对比较,或者根据特定特征的所有组之间的差异的汇总度量。不同的选择可能会导致有关某个时间点的健康差异的大小和方向以及差异随时间变化的不同结论。本文的目的是回顾测量健康差异的方法,提供其用法示例,并提出一些建议。测量性传播疾病(STD)差异的具体建议。
  • 【治疗药物的开发与癌症健康差异计划之间的平行:对减少差异的影响。】 复制标题 收藏 收藏
    DOI:10.1002/cncr.23879 复制DOI
    作者列表:Chu KC,Chen MS Jr,Dignan MB,Taylor E,Partridge E,Community Network Program Principal Investigators.
    BACKGROUND & AIMS: BACKGROUND:There are analogies between the development of therapeutic drugs for cancer and the development of interventions for reducing cancer health disparities. In both cases, it can take between 12 and 15 years for the benefits to become apparent. METHODS:The initial preclinical phase of drug development is analogous to the development of community partnerships and helping the community learn about cancer. The preclinical phase of in vitro and in vivo testing is analogous to identifying the disparities in the community. Then clinical testing begins with phase 1, toxicity, and dose-establishing studies. Analogously, community-based participatory research is used to develop disparities-reducing interventions (DRIs) within the community. RESULTS:The phase 2 clinical studies to determine whether the drug has activity are analogous to the DRI being implemented in the community to determine whether it can cause behavioral changes that will reduce cancer health disparities. If a drug passes phase 1 and 2 studies, phase 3 clinical trials are initiated. These are controlled studies to examine the efficacy of the drug. The similar activity for disparities research is to determine whether the DRI is better than the current standard/usual practice in controlled trials. If the drug is beneficial, the final phase is the dissemination and adoption of the drug. Analogously in disparities, if the DRI is beneficial, it is disseminated and is culturally adapted to other racial/ethnic groups and finally adopted as standard practice. CONCLUSIONS:The process of creating an effective DRI can be envisioned to have 4 stages, which can be used to aid in measuring the progress being made in reducing cancer health disparities.
    背景与目标: 背景:癌症治疗药物的开发与减少癌症健康差异的干预措施的开发之间存在类比。在这两种情况下,收益的显现都可能需要12到15年。
    方法:药物开发的临床前阶段类似于社区伙伴关系的发展,并帮助社区了解癌症。体外和体内测试的临床前阶段类似于确定社区中的差异。然后,临床测试从阶段1,毒性和剂量确定研究开始。类似地,基于社区的参与性研究被用于在社区内开发减少差异的干预措施(DRI)。
    结果:确定该药物是否具有活性的2期临床研究类似于在社区实施的DRI,以确定其是否会引起行为改变,从而减少癌症健康差异。如果药物通过了第1和第2阶段的研究,则将启动第3阶段的临床试验。这些是检查药物疗效的对照研究。差异研究的类似活动是确定DRI是否比对照试验中的当前标准/常规更好。如果药物是有益的,那么最后阶段就是药物的传播和采用。类似地,如果DRI是有益的,则将DRI传播并在文化上适应其他种族/族裔群体,并最终用作标准做法。
    结论:可以将创建有效DRI的过程分为四个阶段,这些阶段可用于帮助衡量减少癌症健康差异方面取得的进展。
  • 【通过临床能力而不仅仅是文化能力来解决心理健康差异:在提供循证心理社会康复服务时需要评估社会文化问题。】 复制标题 收藏 收藏
    DOI:10.1016/j.cpr.2008.07.006 复制DOI
    作者列表:Yamada AM,Brekke JS
    BACKGROUND & AIMS: :Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness.
    背景与目标: :对心理健康服务中种族/种族差异的认识并没有直接导致对文化做出回应的社会心理干预措施的发展。仍然需要对与严重且持续存在精神疾病的文化差异消费者的期望,需求和目标相关联的社会文化问题进行评估。作者认为,将社会文化问题的评估纳入社会心理康复实践是设计与文化相关的,经验支持的实践的第一步。它成为从业人员可以检查其干预措施与日常实践中遇到的多样性的相关性的基础。本文概述了对文化和临床相关评估实践的需求,并断言通过改进对社会文化问题的评估,服务提供商的临床能力得到了增强。作者提供了将社会文化问题的临床评估与消费者成果联系起来的概念框架,并介绍了一种评估工具,该工具适用于促进社会心理康复过程。强调称职的临床评估技能将最终为解决针对患有严重和持续性精神疾病的文化多样性消费者的研究不足的人群提供治疗结果差异的策略。
  • 【美国医疗保险人口中使用导管和透析途径的种族和性别差异。】 复制标题 收藏 收藏
    DOI:10.1681/ASN.2019030274 复制DOI
    作者列表:Arya S,Melanson TA,George EL,Rothenberg KA,Kurella Tamura M,Patzer RE,Hockenberry JM
    BACKGROUND & AIMS: BACKGROUND:Despite efforts to increase arteriovenous fistula and graft use, 80% of patients in the United States start hemodialysis on a central venous catheter (CVC). METHODS:To better understand in incident hemodialysis patients how sex and race/ethnicity are associated with time on a central venous catheter and transition to an arteriovenous fistula and graft, our observational cohort study analyzed US Renal Data System data for patients with incident ESKD aged ≥66 years who started hemodialysis on a CVC in July 2010 through 2013. RESULTS:At 1 year, 32.7% of 74,194 patients transitioned to an arteriovenous fistula, 10.8% transitioned to an arteriovenous graft, 32.1% stayed on a CVC, and 24.5% died. Women spent a significantly longer time on a CVC than men. Compared with white patients, patients who were black, Hispanic, or of another racial/ethnicity minority spent significantly more days on a CVC. In competing risk regression, women were significantly less likely than men to transition to a fistula and more likely to transition to a graft. Compared with white patients, blacks were significantly less likely to transition to a fistula but more likely to transition to a graft, Hispanics were significantly more likely to transition to a fistula, and other races/ethnicities were significantly more likely to transition to either a fistula or a graft. CONCLUSIONS:Female patients spend a longer time on a CVC and are less likely to transition to permanent access. Compared with white patients, minorities also spend longer time on a CVC, but are more likely to eventually transition to permanent access. Strategies to speed transition to permanent access should target groups that currently lag in this area.
    背景与目标: 背景:尽管努力增加动静脉瘘和移植物的使用,美国80%的患者开始通过中央静脉导管(CVC)进行血液透析。
    方法:为了更好地了解事件性血液透析患者的性别和种族/民族与时间在中心静脉导管上以及过渡到动静脉瘘和移植物之间的关系,我们的观察性队列研究分析了美国肾脏数据系统对≥≥ESKD事件的患者的数据。 66岁的人从2010年7月至2013年开始在CVC上进行血液透析。
    结果:在1年中,74194例患者中有32.7%转变为动静脉瘘,10.8%转变为动静脉移植物,32.1%留在CVC上,有24.5%死亡。女性在CVC上花费的时间比男性长得多。与白人患者相比,黑人,西班牙裔或其他少数种族/民族的患者在CVC上花费的时间明显更多。在竞争性风险消退中,女性比男性更不可能转换为瘘管,而更有可能转换为移植物。与白人患者相比,黑人转移到瘘管的可能性要小得多,但移植到瘘管的可能性要大得多,西班牙裔人转移到瘘管的可能性要大得多,其他种族/族裔的人转移到任一瘘管的可能性都更大或嫁接。
    结论:女性患者在CVC上花费的时间更长,并且不太可能过渡到永久使用。与白人患者相比,少数族裔在CVC上花费的时间也更长,但最终过渡到永久性访问的可能性更大。加快向永久访问权过渡的策略应针对当前滞后于该领域的人群。
  • 【在美国,降低大肠癌发病率和阶段的黑白差异。】 复制标题 收藏 收藏
    DOI:10.1158/1055-9965.EPI-16-0834 复制DOI
    作者列表:May FP,Glenn BA,Crespi CM,Ponce N,Spiegel BMR,Bastani R
    BACKGROUND & AIMS: :Background: There are long-standing black-white disparities in colorectal cancer incidence and outcomes in the United States. Incidence and stage at diagnosis reflect the impact of national efforts directed at colorectal cancer prevention and control. We aimed to evaluate trends in black-white disparities in both indicators over four decades to inform the future direction of prevention and control efforts.Methods: We used Surveillance, Epidemiology, & End Results (SEER) data to identify whites and blacks with histologically confirmed colorectal cancer from January 1, 1975 through December 31, 2012. We calculated the age-adjusted incidence and the proportion of cases presenting in late stage by race and year. We then calculated the annual percentage change (APC) and average APC for each indicator by race, examined changes in indicators over time, and calculated the incidence disparity for each year.Results: There were 440,144 colorectal cancer cases from 1975 to 2012. The overall incidence decreased by 1.35% and 0.46% per year for whites and blacks, respectively. Although the disparity in incidence declined from 2004 to 2012 (APC = -3.88%; P = 0.01), incidence remained higher in blacks in 2012. Late-stage disease declined by 0.27% and 0.45% per year in whites and blacks, respectively. The proportion of late-stage cases became statistically similar in whites and blacks in 2010 (56.60% vs. 56.96%; P = 0.17).Conclusions: Black-white disparities in colorectal cancer incidence and stage at presentation have decreased over time.Impact: Our findings reflect the positive impact of efforts to improve colorectal cancer disparities and emphasize the need for interventions to further reduce the incidence gap. Cancer Epidemiol Biomarkers Prev; 26(5); 762-8. ©2016 AACR.
    背景与目标: 背景:在美国,结直肠癌的发病率和结局存在长期的黑白差异。诊断的发生率和阶段反映了针对大肠癌预防和控制的国家努力的影响。我们旨在评估四个指标中黑白差异的趋势,以期为未来的预防和控制工作指明方向。方法:我们使用监测,流行病学和最终结果(SEER)数据来识别经组织学确认的白人和黑人1975年1月1日至2012年12月31日的大肠癌。我们按种族和年份计算了年龄调整后的发病率和晚期病例的比例。然后,我们按种族计算了每个指标的年度百分比变化(APC)和平均APC,检查了指标随时间的变化,并计算了每年的发病率差异。结果:从1975年到2012年,有440,144例大肠癌病例。总体白人和黑人的发病率每年分别下降1.35%和0.46%。尽管从2004年到2012年发病率差异有所下降(APC = -3.88%; P = 0.01),但2012年黑人发病率仍较高。白人和黑人的晚期疾病每年分别下降0.27%和0.45%。 2010年白人和黑人的晚期病例比例在统计学上相似(56.60%vs.56.96%; P = 0.17)。结论:随着时间的推移,大肠癌发病率和分期中的黑白差异有所减少。我们的发现反映了改善大肠癌差异的努力的积极影响,并强调了采取干预措施以进一步减少发病率差距的必要性。癌症流行病生物标志物26(5); 762-8。 ©2016 AACR。
  • 【美国2型糖尿病患者在初级保健质量方面与保险有关的差异。】 复制标题 收藏 收藏
    DOI:10.1186/s12939-016-0413-x 复制DOI
    作者列表:Lee DC,Liang H,Shi L
    BACKGROUND & AIMS: BACKGROUND:This study explored insurance-related disparities in primary care quality among Americans with type 2 diabetes. METHODS:Data came from the household component of the 2012 Medical Expenditure Panel Survey (MEPS). Analysis focused on adult subjects with type 2 diabetes. Logistic regressions were performed to investigate the associations between insurance status and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, while controlling for confounding factors. RESULTS:Preliminary findings revealed differences among three insurance groups in the first contact domain of primary care quality. After controlling for confounding factors, these differences were no longer apparent, with all insurance groups reporting similar primary care quality according to the four domains of interest in the study. There were significant differences in socioeconomic status among different insurance groups. CONCLUSION:This study reveals equitable primary care quality for diabetes patients despite their health insurance status. In addition to insurance-related differences, the other socioeconomic stratification factors are assumed to be the root cause of disparities in care. This research emphasizes the crucial role that primary care plays in the accessibility and quality of care for chronically ill patients. Policy makers should continue their commitment to reduce gaps in insurance coverage and improve access as well as quality of diabetic care.
    背景与目标: 背景:本研究探讨了美国2型糖尿病患者在保险方面的基本医疗质量差异。
    方法:数据来自2012年医疗支出小组调查(MEPS)的家庭部分。分析集中于患有2型糖尿病的成人受试者。进行逻辑回归分析,以调查保险状况与与首次接触,纵向,全面性和协调性相关的初级保健属性之间的关联,同时控制混杂因素。
    结果:初步发现显示,在初级保健质量的首次接触领域中,三个保险集团之间存在差异。在控制了混杂因素之后,这些差异不再明显,根据研究的四个领域,所有保险集团都报告了相似的初级保健质量。不同保险集团之间的社会经济地位存在显着差异。
    结论:本研究揭示了尽管糖尿病患者具有健康保险状态,但他们仍享有公平的初级保健质量。除了与保险有关的差异外,其他社会经济分层因素也被认为是医疗服务差异的根本原因。这项研究强调了初级保健在慢性病患者的可及性和医疗质量中的关键作用。决策者应继续致力于减少保险覆盖率的差距,并改善糖尿病护理的可及性和质量。
  • 【博茨瓦纳新出现的卫生差距:在艾滋病流行期间检查孤儿的状况。】 复制标题 收藏 收藏
    DOI:10.1016/j.socscimed.2007.03.002 复制DOI
    作者列表:Miller CM,Gruskin S,Subramanian SV,Heymann J
    BACKGROUND & AIMS: :Botswana has the second highest HIV prevalence rate and highest rate of orphanhood in the world. Although child mortality rates have doubled in 15 years, the extent to which health disparities are connected to orphan status remains unclear. We conducted an analysis of the 2000 Botswana Multiple Indicator Cluster Survey to examine whether orphan-based health disparities exist. We measured health inequalities using anthropometric data among 2723 under-five year olds, nested in 1854 households, and 208 communities. We calculated multilevel logistic regression models to estimate the child, household, and regional determinants of growth failure. We found that orphaned children aged 0-4 are 49% more likely to be underweight than nonorphans (p<0.05) controlling for household poverty and other factors; and orphans disproportionately live in the poorest households. Throughout sub-Saharan Africa (SSA), Botswana is a leader in responding to the AIDS epidemic, in particular as one of the first countries to offer universal antiretroviral treatment. However, orphan-based health disparities confirm that the orphan response is still insufficient. Better data are needed to fully understand the mechanisms that lead to these disparities, and the public sector needs an increased capacity to fully implement the policies and programs designed to meet the needs of orphans. Findings from this study have important implications for countries throughout SSA, and Southern Africa in particular, where the number of orphans has doubled to tripled over the past 15 years.
    背景与目标: :博茨瓦纳的艾滋病毒感染率是全球第二高,孤儿率最高。尽管儿童死亡率在15年内翻了一番,但健康差异与孤儿状况有关的程度仍不清楚。我们对2000年博茨瓦纳多指标类集调查进行了分析,以检查是否存在基于孤儿的健康差异。我们使用人体测量学数据测量了2854名1854个家庭和208个社区的5岁以下儿童的健康不平等状况。我们计算了多级逻辑回归模型来估计儿童,家庭和区域性成长失败的决定因素。我们发现,在控制家庭贫困和其他因素的情况下,0-4岁的孤儿比非孤儿的体重过轻的可能性高49%(p <0.05);孤儿不成比例地生活在最贫穷的家庭中。在整个撒哈拉以南非洲地区(SSA),博茨瓦纳是应对艾滋病流行的领导者,特别是作为首批提供普遍抗逆转录病毒治疗的国家之一。但是,基于孤儿的健康差异证实了孤儿的反应仍然不足。需要更好的数据来充分理解导致这种差距的机制,公共部门需要增强能力,以充分执行旨在满足孤儿需求的政策和方案。这项研究的发现对整个撒哈拉以南非洲地区尤其是南部非洲的国家都具有重要意义,在过去的15年中,这些国家的孤儿人数翻了一番,达到了两倍。
  • 【疗养院居民中流感和肺炎球菌疫苗接种中的种族/种族差异:系统评价。】 复制标题 收藏 收藏
    DOI:10.1093/geront/gnw193 复制DOI
    作者列表:Travers JL,Schroeder KL,Blaylock TE,Stone PW
    BACKGROUND & AIMS: :This systematic review analyzes research examining racial/ethnic disparities in influenza and pneumococcal vaccination coverage between White and racial/ethnic minority (Black and Hispanic) nursing home residents. A review of the literature for years 1966-2014 using Medline, Web of Science, and PubMed was conducted. The Epidemiological Appraisal Instrument was used to appraise the quality of the 13 included studies. Overall, articles were strong in reporting and data analysis, but weak in sample selection and measurement quality. Disparities between vaccination coverage among racial/ethnic minorities versus Whites ranged from 2% to 20% for influenza and 6% to 15% for pneumococcal vaccination. Researchers reported racial/ethnic minorities were more likely to refuse vaccinations and less likely to have vaccinations offered and their vaccination status tracked compared to Whites. Policies/strategies that focus on ensuring racial/ethnic minorities are offered influenza and pneumococcal vaccinations and their vaccination status are tracked in nursing homes are warranted. Updated evaluation on vaccination disparities is also needed.
    背景与目标: :这篇系统的综述分析了研究白人和种族/少数民族(黑人和西班牙裔)疗养院居民之间在流感和肺炎球菌疫苗接种覆盖率方面的种族/种族差异。使用Medline,Web of Science和PubMed对1966-2014年的文献进行了回顾。流行病学评估工具用于评估13项纳入研究的质量。总体而言,文章在报告和数据分析方面表现出色,但在样品选择和测量质量方面表现不佳。种族/族裔少数民族与白人之间的疫苗接种覆盖率之间的差异在流感的2%至20%和肺炎球菌疫苗的6%至15%之间。研究人员报告说,与白人相比,种族/族裔少数群体拒绝接种疫苗的可能性更高,提供疫苗接种的可能性也更低,并且追踪其接种状况的可能性也较小。着重确保向种族/族裔少数群体提供流感和肺炎球菌疫苗的政策/策略应得到保证,并在疗养院中跟踪其疫苗接种状况。还需要对疫苗接种差异进行最新评估。
  • 【美国胸科学会和欧洲呼吸学会的正式政策声明:呼吸健康方面的差异。】 复制标题 收藏 收藏
    DOI:10.1183/09031936.00062113 复制DOI
    作者列表:Schraufnagel DE,Blasi F,Kraft M,Gaga M,Finn P,Rabe KF
    BACKGROUND & AIMS: :Health disparities, defined as a significant difference in health between populations, are more common for diseases of the respiratory system than for those of other organ systems, because of the environmental influence on breathing and the variation of the environment among different segments of the population. The lowest social groups are up to 14 times more likely to have respiratory diseases than are the highest. Tobacco smoke, air pollution, environmental exposures, and occupational hazards affect the lungs more than other organs and occur disproportionately in ethnic minorities and those with lower socioeconomic status. Lack of access to quality healthcare contributes to disparities. The executive committees of the American Thoracic Society (ATS) and European Respiratory Society (ERS) established a writing committee to develop a policy on health disparities. The document was reviewed, edited, and approved by their full executive committees and boards of directors of the societies. This document expresses a policy to address health disparities by promoting scientific inquiry and training, disseminating medical information and best practices, and monitoring and advocating for public respiratory health. The ERS and the ATS have strong international commitments and work with leaders from governments, academia, and other organisational bodies to address and reduce avoidable health inequalities. Their training initiatives improve the function of healthcare systems and health equality. Both the ATS and the ERS support all aspects of this document, confer regularly, and act together when possible, but the activities to bring about change may vary because of the differences in the continents where the two organisations carry out most of their activities. The ATS and ERS pledge to frame their actions to reduce respiratory health disparities. The vision of the ATS and ERS is that all persons attain better and sustained respiratory health. They call on all their members and other societies to join in this commitment.
    背景与目标: :由于人口对环境的影响以及不同人群之间环境的变化,健康差异被定义为人群之间健康的显着差异,因此呼吸系统疾病比其他器官系统更常见。最低的社会群体患呼吸道疾病的可能性是最高的群体的14倍。烟草烟雾,空气污染,环境暴露和职业危害对肺部的影响比其他器官更多,并且在少数民族和社会经济地位较低的人群中不成比例地发生。缺乏优质医疗保健的机会加剧了差距。美国胸科学会(ATS)和欧洲呼吸学会(ERS)的执行委员会成立了一个写作委员会,以制定有关健康差异的政策。该文件由其整个执行委员会和协会董事会进行了审核,编辑和批准。该文件表达了一项政策,旨在通过促进科学探究和培训,传播医学信息和最佳实践以及监测和倡导公共呼吸健康来解决健康差异。 ERS和ATS拥有强大的国际承诺,并与政府,学术界和其他组织机构的领导人合作,以解决和减少可避免的健康不平等现象。他们的培训计划改善了医疗保健系统的功能和健康平等。 ATS和ERS都支持本文档的各个方面,定期举行会议,并在可能的情况下共同行动,但是,由于两个组织执行其大部分活动的大陆不同,因此带来变革的活动可能会有所不同。 ATS和ERS承诺采取行动减少呼吸系统健康差异。 ATS和ERS的愿景是所有人都能获得更好和持续的呼吸健康。他们呼吁所有成员和其他社会加入这一承诺。
  • 【传染病的产前筛查:加州差异和政策遵守情况的分析。】 复制标题 收藏 收藏
    DOI:10.1007/s10995-008-0341-5 复制DOI
    作者列表:Sheikh LA,Sarnquist C,Grieb EM,Sullivan B,Maldonado YA
    BACKGROUND & AIMS: OBJECTIVES:Prenatal infectious diseases are a major cause of mortality and morbidity among newborns, but many are preventable with proper maternal screening and treatment. METHODS; Adherence to prenatal infectious disease screening guidelines and demographic factors that influence adherence were determined utilizing existing data on 1837 live births from 1999-2003. RESULTS:We found higher rates of testing for syphilis (94.54%), rubella (92.69%) and hepatitis B (94.23%) than for HIV (73.82%) and GBS (69.05%). Adherence to testing guidelines varied by both disease and maternal factors. Lack of insurance, geographic location, inadequate prenatal care and incarceration were the main maternal factors associated with lack of testing. CONCLUSIONS:Disease screening rates may be improved by reducing socioeconomic barriers to prenatal testing, supporting access to insurance, eliminating provider biases and providing adequate prenatal care.
    背景与目标: 目的:产前传染病是新生儿死亡和发病的主要原因,但通过适当的母亲筛查和治疗可以预防许多疾病。方法;利用1999-2003年间1837例活产的现有数据,确定是否遵守产前传染病筛查指南和影响依从性的人口统计学因素。
    结果:我们发现梅毒(94.54%),风疹(92.69%)和乙型肝炎(94.23%)的检测率高于HIV(73.82%)和GBS(69.05%)的检测率。遵循测试指南的情况因疾病和孕产妇因素而异。缺乏保险,地理位置,产前护理不足和监禁是缺乏检测的主要产妇因素。
    结论:可以通过减少产前检查的社会经济障碍,支持获得保险,消除医疗服务提供者的偏见以及提供适当的产前保健来提高疾病筛查率。
  • 【减少口腔健康差异:关注社会和文化决定因素。】 复制标题 收藏 收藏
    DOI:10.1186/1472-6831-6-S1-S4 复制DOI
    作者列表:Patrick DL,Lee RS,Nucci M,Grembowski D,Jolles CZ,Milgrom P
    BACKGROUND & AIMS: :Oral health is essential to the general health and well-being of individuals and the population. Yet significant oral health disparities persist in the U.S. population because of a web of influences that include complex cultural and social processes that affect both oral health and access to effective dental health care. This paper introduces an organizing framework for addressing oral health disparities. We present and discuss how the multiple influences on oral health and oral health disparities operate using this framework. Interventions targeted at different causal pathways bring new directions and implications for research and policy in reducing oral health disparities.
    背景与目标: :口腔健康对于个人和人群的整体健康和福祉至关重要。然而,由于一系列影响因素(包括影响口腔健康和获得有效牙齿保健服务的复杂的文化和社会过程),美国人口中仍然存在严重的口腔健康差异。本文介绍了解决口腔健康差异的组织框架。我们介绍并讨论如何使用此框架对口腔健康和口腔健康差异产生多重影响。针对不同因果途径的干预措施对减少口腔健康差异的研究和政策提出了新的方向和启示。
  • 【脊髓损伤后结局方面的种族差异。】 复制标题 收藏 收藏
    DOI:10.1089/neu.2012.2540 复制DOI
    作者列表:Lad SP,Umeano OA,Karikari IO,Somasundaram A,Bagley CA,Gottfried ON,Isaacs RE,Ugiliweneza B,Patil CG,Huang K,Boakye M
    BACKGROUND & AIMS: :Spinal Cord Injury (SCI) is an acute trauma to the neural elements resulting in temporary or permanent sensory and motor deficit. Studies have indicated that although 66% of SCI occur in Caucasians, there are a growing number of other racial groups affected by SCI. Furthermore, there has been a lack of research concerning racial disparities in outcomes following SCI. As such, a retrospective analysis using the National Trauma Data Bank (NTDB) from 2000 to 2009 was performed. African Americans, Caucasians, Hispanics, Asians, and Native Americans were included in the study. We calculated adjusted odds ratios (OR) to examine the relationship between racial backgrounds and mortality, length of intensive care unit (ICU) stay, length of hospital stay, in-hospital complications, and patient disposition. Our results showed that significant differences were found in length of hospital stay, with African American and Hispanic populations having longer hospital stays than Caucasian and Asians. For all type complications, African Americans (OR 1.228, confidence interval [CI] 1.11-1.356) and Native Americans (OR 1.618, CI 1.083-2.419) were more likely than Caucasian and Hispanic patients to have in-hospital complications. For disposition status, African Americans (OR 0.844, CI 0.730-0.976) and Asians (OR 0.475, CI 0.297-0.760) were much less likely than Caucasians or Hispanic populations to be discharged to an acute rehabilitation program. The results from this large-scale study (n=18,671) demonstrate a number of racial disparities following SCI at the national level, including rate of complications, length of stay, and disposition to acute rehabilitation centers. This should raise awareness to cultural differences but also serve as an opportunity to reduce gaps in care across ethnicities for this universally life-altering condition.
    背景与目标: :脊髓损伤(SCI)是神经元的急性损伤,导致暂时或永久的感觉和运动障碍。研究表明,尽管66%的SCI发生在高加索人中,但仍有越来越多的其他种族受到SCI的影响。此外,缺乏关于SCI后结局中种族差异的研究。因此,使用国家创伤数据库(NTDB)对2000年至2009年进行了回顾性分析。这项研究包括非裔美国人,高加索人,西班牙裔,亚裔和美洲原住民。我们计算了校正后的优势比(OR),以检查种族背景与死亡率,重症监护病房(ICU)住院时间,住院时间,医院内并发症以及患者处置之间的关系。我们的结果表明,住院时间的长短存在显着差异,非洲裔美国人和西班牙裔人的住院时间比白种人和亚洲人长。对于所有类型的并发症,非洲裔美国人(OR 1.228,置信区间[CI] 1.11-1.356)和美洲印第安人(OR 1.618,CI 1.083-2.419)比白种人和西班牙裔患者更有可能发生院内并发症。就处置状态而言,非裔美国人(OR 0.844,CI 0.730-0.976)和亚洲人(OR 0.475,CI 0.297-0.760)被排除在白人或拉美裔人群的急性康复计划之外的可能性要小得多。这项大规模研究的结果(n = 18,671)表明,在国家一级实施SCI后,存在许多种族差异,包括并发症发生率,住院时间和对急性康复中心的处置。这应该提高人们对文化差异的认识,同时也为减少这种普遍改变生活状况的族裔之间在照料方面的差距提供机会。
  • 【解决美国和全球大肠癌筛查率和差异的策略和资源。】 复制标题 收藏 收藏
    DOI:10.1146/annurev-publhealth-031912-114436 复制DOI
    作者列表:Potter MB
    BACKGROUND & AIMS: :Colorectal cancer is a significant cause of mortality in the United States and globally. In the United States, increased access to screening and effective treatment has contributed to a reduction in colorectal cancer incidence and mortality for the general population, though significant disparities persist. Worldwide, the disparities are even more pronounced, with vastly different colorectal cancer mortality rates and trends among nations. Newly organized colorectal cancer screening programs in economically developed countries with a high burden of colorectal cancer may provide pathways to reduce these disparities over time. This article provides an overview of colorectal cancer incidence, mortality, screening, and disparities in the United States and other world populations. Promising strategies and resources are identified to address colorectal cancer screening rates and disparities in the United States and worldwide.
    背景与目标: 在美国和全球,结直肠癌是导致死亡的重要原因。在美国,尽管仍然存在重大差距,但增加筛查和有效治疗的机会有助于降低普通人群的结直肠癌发病率和死亡率。在世界范围内,这种差异更加明显,各国之间大肠癌的死亡率和趋势存在很大差异。在经济发达的国家中,结直肠癌负担很重的新组织的结直肠癌筛查计划可能会为减少这些差异提供途径。本文概述了美国和其他世界人群中大肠癌的发病率,死亡率,筛查和差异。确定有前途的策略和资源来解决美国和全球范围内的大肠癌筛查率和差异。
  • 【中老年人和以色列成年人在残疾方面的种族差异:社会经济劣势和创伤性生活事件的作用。】 复制标题 收藏 收藏
    DOI:10.1177/0898264313478653 复制DOI
    作者列表:Osman A,Walsemann KM
    BACKGROUND & AIMS: OBJECTIVE:We examined the contribution of socioeconomic disadvantage and traumatic life events to ethnic disparities in disability among Israeli adults. METHOD:We used data from the Survey of Health, Aging and Retirement in Europe (SHARE-Israel), a sample of Israeli adults aged 50 or older (N = 1,546). Disability measures included functional limitations, limitations in activities of daily living (ADL), and limitations in instrumental activities of daily living (IADL). RESULTS:Arabs and immigrants from the Former Soviet Union (FSU) experienced higher rates of functional limitations and limitations in IADLs compared to veteran Jews. The rate of having limitations in ADLs was similar for Arabs and veteran Jews, but was higher for FSU immigrants compared to veteran Jews. Inclusion of education, income, and traumatic life events attenuated, but did not eliminate ethnic disparities in disability. DISCUSSION:Identifying factors driving ethnic health disparities in Israel is imperative if we hope to achieve health equity.
    背景与目标: 目的:我们研究了社会经济劣势和创伤性生活事件对以色列成年人中残疾人种族差异的影响。
    方法:我们使用了来自欧洲健康,老龄化和退休调查(SHARE-以色列)的数据,该数据是年龄在50岁或以上(N = 1,546)的以色列成年人的样本。残疾措施包括功能限制,日常生活活动的限制(ADL)和日常生活活动的限制(IADL)。
    结果:与经验丰富的犹太人相比,来自前苏联(FSU)的阿拉伯人和移民经历了更高的功能限制和IADL限制。阿拉伯人和经验丰富的犹太人对ADL的限制率相似,但与经验丰富的犹太人相比,FSU移民的ADL受到限制的比率更高。对教育,收入和创伤性生活事件的包容性减弱了,但并没有消除残疾方面的种族差异。
    讨论:如果我们希望实现健康平等,必须确定导致以色列种族健康差异的因素。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录