アメリカ合衆国とイギリスにおける病気と不利な状況
James Banks1, Michael Marmot, Zoe Oldfield
1University College London and Institute for Fiscal Studies, London, England.
JAMA
|May 4, 2006
まとめ
55歳から64歳までの米国の成人は,イギリスの同級生よりも健康状態が悪く,糖尿病や心臓病などの慢性疾患の罹患率が高くなります. これらの健康格差は,すべての社会経済的地位 (SES) レベルにおいて持続しています.
科学分野:
- 比較医療研究 比較医療研究
- 健康の社会経済的決定要因
- ゲロントロジーはゲロントロジーの学科です.
背景:
- 米国の医療費は英国の医療費を上回っているが,比較医療成果は不明である.
- 米国と英国の健康状態の違いを理解することは,公衆衛生政策にとって極めて重要です.
研究 の 目的:
- イギリスと米国の高齢者 (55歳から64歳) の健康状態を比較する.
- 社会経済状況の指標が,両国間の健康の変動にどのように影響するかを調査する.
主な方法:
- 米国保健・退職調査 (n=4386) と英国老化研究 (n=3681) の代表的なサンプル分析.
- 生物学的疾患マーカーを含む,国立保健栄養調査調査とイングランド保健調査からの追加データを含める.
- 人種/民族の健康格差をコントロールするために,非ヒスパニック系白人人口に焦点を当てます.
主要な成果:
- 55歳から64歳までのアメリカ人は,イギリス人よりも健康状態が悪く,糖尿病,高血圧,心臓病,脳卒中,肺疾患,がんの罹患率が高くなります.
- 両国とも社会経済的地位 (SES) の著しい格差が観察され,低所得層や教育レベルでは健康格差が広がった.
- 生物学的マーカーは自己報告データを確認し,米国における糖尿病の2倍の罹患率を示し,イギリスと比較してC反応性タンパク質の上昇とHDLコレステロールの低下を示した.
結論:
- 55歳から64歳までの米国の住民は,自己報告の病気と客観的な生物学的マーカーの両方によって証明される,英語の同僚よりも健康性が著しく低下しています.
- 社会経済的地位に関連した健康格差は,両国のすべての分布レベルで存在しますが,米国ではより顕著です.
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