子供の機会指数と個人レベルの社会的リスクとの関連
Florinda Islamovic1, Samantha Levano1,2, Hemen Muleta1
1Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore Einstein, Bronx, NY.
Journal of pediatrics. Clinical practice
|September 2, 2025
まとめ
チャイルド・オポチュニティ・インデックス (COI) は,子どもの個別の健康関連社会ニーズ (HRSN) の不適切な指標です. COI 3.0は,COI 2.0よりもこれらのニーズを特定する上で改善を示した.
科学分野:
- 小児の健康
- 健康の社会的決定因子
- 健康に関する公平性
背景:
- チャイルド・オッポニチュリティ・インデックス (COI) のような地域レベルの指標は,個人の健康関連社会ニーズ (HRSN) のプロキシとして使用されます.
- 現存する文献は,これらの面積レベルのインデックスを使用する際の限界を示唆しています.
- 特に小児集団におけるCOIと個々のHRSNの関係を評価した以前の研究はありませんでした.
研究 の 目的:
- 子どもの機会指数 (COI) バージョン2.0と3.0と個人レベルの健康関連社会ニーズ (HRSN) の関係を評価する.
- 小児患者のHRSNを特定するためのプロキシとしてCOIの有用性を評価する.
主な方法:
- 大規模な学術病院でHRSNを検診した小児患者の横断的な研究.
- HRSNと地理的識別子を持つ 17,760人の子供を含む.
- 多変数ロジスティック回帰モデルは,予測能力の計算を含むCOI tertilesとHRSNsの間の関連を分析します.
主要な成果:
- 国家標準化COI 3.0は,中等 (OR 1.57) と低 (OR 2.34) の機会領域におけるHRSNの確率が,高い機会領域と比較して,著しく高いことを示した.
- 州標準化COI3.0は,機会が低い地域でのみHRSNの確率が高いことを示した (OR1.87).
- HRSNとCOI2. 0またはメトロポリタン標準化COI3. 0との間に有意な関連性は見つかりませんでした.
結論:
- 子どもの機会指数 (COI) は文脈的な指標として機能しますが,個々の健康関連社会ニーズ (HRSN) の不適切な代理です.
- COI 2.0から3.0までの改善は,インデックスの継続的な開発と更新の重要性を強調しています.
- 地域レベルでのインデックスを改善し,個人レベルでの健康需要の評価を進めるため,さらなる研究が必要になる可能性があります.
関連する概念動画
Relative Risk
340
Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
340
Influence of Parents and Peers on Identity
127
Adolescence is a pivotal period of identity formation, during which individuals begin to answer questions central to their sense of self, such as "Who am I?" and "Who do I hope to become?" Both parents and peers play critical roles in guiding adolescents through this complex developmental phase.
Parental Influence on Identity Development
Parents serve as primary guides and managers in an adolescent's life, offering support instrumental in decision-making and personal growth....
Parental Influence on Identity Development
Parents serve as primary guides and managers in an adolescent's life, offering support instrumental in decision-making and personal growth....
127
Erikson's Theory on Socioemotional Development during Childhood
204
Erik Erikson, a stage theorist, adapted Freud's theory to emphasize social factors in personality development throughout life, a concept known as psychosocial development. Unlike Freud, who focused on early childhood, Erikson believed that personality evolves across eight life stages, each marked by a specific challenge or "crisis." Successful resolution of each stage fosters competence, while failure may lead to feelings of inadequacy.
The first four of Erikson's eight...
The first four of Erikson's eight...
204
Socioemotional Development during Infancy
115
Socio-emotional development in infancy is primarily shaped by early emotional responses and social connections, with temperament playing a central role. Temperament refers to the consistent patterns in an individual's emotional and behavioral responses, observable even in infancy. By examining temperament, researchers can better understand an infant's unique ways of interacting with the world, influencing subsequent personality and socio-emotional growth.
Primary Temperament Types
Primary Temperament Types
115
Erikson's Theory on Socioemotional Development during Adolescence
353
Erik Erikson's fifth stage of psychosocial development, "identity versus role confusion," is crucial during adolescence (ages 12 to 18). In this stage, adolescents face the developmental task of forging a distinct personal identity, a process influenced by social, psychological, and biological changes typical of this period. Adolescents naturally explore different roles, behaviors, and ideologies as they navigate complex questions of self-concept, asking, "Who am I?" and "What is my place in...
353
Hazard Ratio
241
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
241


