当地社会脆弱性作为美国各县癌症相关死亡率的预测因素
Krista Y Chen1, Amanda L Blackford2, Ramy Sedhom3
1Johns Hopkins School of Medicine, Baltimore, MD, USA.
The oncologist
|June 19, 2023
概括
社会脆弱性对美国各县的癌症死亡率产生重大影响. 在社会上处于不利地位的地区,特别是南部和农村地区,癌症死亡风险更高,突出了健康不平等.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康差距 研究 研究 研究 研究
背景情况:
- 美国各县的医疗保健支出和癌症死亡率存在显著差异.
- 社会脆弱性是影响健康结果的关键因素,但它对癌症死亡率的影响需要进一步调查.
研究的目的:
- 调查美国县级社会脆弱性与癌症相关死亡率之间的关联.
- 鉴定特定的人口和地理群体因社会脆弱性而受到癌症死亡率不成比例的影响.
主要方法:
- 横截面分析将来自CDC数据的县级年龄调整死亡率 (AAMR) 与社会脆弱性指数 (SVI) 联系起来.
- SVI纳入了15个社会因素 (社会经济地位,人口统计,住房,交通).
- 强大的线性回归模型比较了最弱势县和最弱势县之间的AAMR.
主要成果:
- 总体而言,AAMR为每10万个人的173人,死亡人数为4,107,273人.
- 在老年人,男性,非西班牙裔黑人个体和农村/南部县观察到的最高AAMR.
- 在最弱势和最弱势县之间,死亡风险的最大增加出现在南方/农村地区,45-65岁的个体,以及肺癌和结直肠癌.
结论:
- 社会脆弱的县,特别是美国南部和农村地区,面临更高的癌症死亡风险.
- 特定的人群 (例如中年成人,非西班牙裔黑人) 和癌症类型 (肺癌,结肠直肠癌) 受影响不成比例.
- 调查结果支持增加对社会不利地区的投资,以解决卫生不平等问题.
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