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跨越25年的财务压力和女性膀健康:一个生命过程的视角
Sonya S Brady1, Andrés Arguedas2, Jared D Huling2
1Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN.
American journal of obstetrics and gynecology
|October 1, 2023
概括
财务压力显著增加了女性下尿道症状 (LUTS) 的风险. 获得医疗保健和并发症调解了这种关联,突出了社会决定因素对妇女健康的影响.
科学领域:
- 公共卫生 公共卫生
- 健康的社会决定因素
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 财务不安全是健康的社会决定因素,与下泌尿道症状 (LUTS) 有关.
- 之前的横截面研究表明,财务压力和LUTS之间存在关联.
- 获得医疗保健和并发症的调解作用仍未得到充分研究.
研究的目的:
- 调查女性的财务压力和LUTS之间的纵向关联.
- 检查医疗保健的获取和并发症是否调解了财务压力和LUTS之间的关系.
- 分析25年来与LUTS相关的财务压力轨迹.
主要方法:
- 841名黑人和白人女性 (基线年龄为18-30岁) 的前性队列研究.
- 在25年的7个时间点 (1985-2011) 中评估了财务压力.
- 使用集群分析对LUTS和影响进行分类;使用回归和结构方程建模进行中介分析.
主要成果:
- 与持续或间歇性财务紧张的女性相比,与持续不紧张的女性相比,报告更高的LUTS和影响的几率大约是两倍.
- 医疗保健利用不足和并发性疾病调解了医疗保健支付困难和LUTS之间的关联.
- 调解途径解释了整个协会,消除了医疗保健支付困难和LUTS之间的直接联系.
结论:
- 医疗保健未充分利用和并发病症解释了财务压力和妇女的LUTS之间的联系.
- 需要进一步的研究来确认这些发现,并探索其他机制.
- 证据可以为未来的健康政策和实践提供信息,以解决健康的社会决定因素.
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