一个贝叶斯的多层次分析,探索人口层面的影响,调解区域层面的贫困和加利福尼亚社区社区中社区获得的抗甲基金色葡萄球菌 (CA-MRSA) 感染之间的关系
Brittany L Morgan Bustamante1, Larissa May2, Laura Fejerman3
1Public Health Sciences, School of Medicine, University of California, Davis, CA, United States; Center for Animal Disease Modeling and Surveillance, Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, United States.
Health & place
|July 29, 2023
概括
区域级贫困与社区获得的抗甲素黄金葡萄球菌 (CA-MRSA) 感染有关. 这种联系部分归因于诸如获得初级保健和邻里环境等因素,特别是在高贫困地区.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康的社会决定因素
背景情况:
- 贫困是健康差距的一个已知的驱动因素.
- 贫困和社区获得的抗甲素黄金葡萄球菌 (CA-MRSA) 感染之间的关联已被记录.
- 将贫困与CA-MRSA感染联系起来的途径需要进一步研究.
研究的目的:
- 确定介导变量,解释地区贫困与加州人中CA-MRSA感染之间的关联.
- 调查生活在初级保健短缺地区 (HCSA),接近惩戒设施或环境退化是否调解了这种关系.
主要方法:
- 利用贝叶斯的多层次模型与空间混调整.
- 测试了HCSA的调解效应,惩戒设施的近距离和环境退化.
- 分析了加利福尼亚社区的数据.
主要成果:
- 区域级贫困和CA-MRSA感染之间的关联部分是由空间自相关性,HCSA状态和邻近环境退化介导的.
- 这些媒介解释了高贫困地区CA-MRSA感染几率的约6%.
- 在贫困较低的社区,调解员完全解释了贫困和感染之间的统计联系.
结论:
- 空间自相关性,HCSA和环境退化是将区域级贫困与CA-MRSA感染联系起来的重要媒介.
- 贫困对CA-MRSA感染风险的影响取决于背景,与贫困水平有很大差异.
- 了解这些途径对于有针对性的公共卫生干预来减少CA-MRSA差异至关重要.
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