解释不平等的趋势:来自巴西儿童健康研究的证据
C G Victora1, J P Vaughan, F C Barros
1Post-Graduate Programme in Epidemiology, Federal University of Pelotas, Brazil.
Lancet (London, England)
|September 29, 2000
概括
儿童健康不平等最初会随着新的健康计划有利于富人而恶化. 反向公平假设解释了这些差异如何随着时间的推移而演变,最终随着穷人获得机会而改善.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康 公平 研究 健康 公平 研究
背景情况:
- 国际上,人们对各国内部和各国之间的儿童健康不平等现象日益恶化表示担忧.
- 反向公平假设提供了一个框架来理解随着时间的推移健康差异的动态变化.
- 社会经济地位显著影响到公共卫生干预措施的获取和结果.
研究的目的:
- 通过巴西的儿童健康数据来检查"反向公平假设".
- 分析儿童健康不平等的时间趋势及其与社会经济地位的关系.
- 评估新的公共卫生干预措施是否最初加剧或减轻健康差异.
主要方法:
- 利用三个流行病学数据集来追踪巴西儿童健康不平等.
- 分析了疾病和死亡率指标不平等比率的时间趋势.
- 与社会经济梯度相关的健康状况改善的比较.
主要成果:
- 观察到儿童发病率和死亡率不平等比率的时间趋势与反向公平假设一致.
- 证明了不平等在改善之前恶化,尽管健康获得了绝对的好处.
- 强调了基于社会经济地位的干预措施随着时间的推移所产生的差异性影响.
结论:
- 反向公平假设为理解儿童健康不平等的波动提供了一个有效的模型.
- 健康平等的改善并不总是线性的,并且可能会先后出现差距加剧的时期.
- 需要有针对性的战略,以确保所有社会经济群体均可获得公共卫生干预措施.
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