美国保险成年人血糖控制中的种族和民族差异
Nora I Zakaria1, Parisa Tehranifar1, Blandine Laferrère2
1Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
JAMA network open
|October 5, 2023
概括
血糖控制方面的种族和民族差异在美国有保险的糖尿病成年人中仍然存在. 即使获得护理,健康状况和医疗利用等因素也会扩大这些差距,突出进一步研究的需要.
科学领域:
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
- 糖尿病管理 糖尿病管理
背景情况:
- 缺乏医疗保健和缺乏医疗保险,导致血糖控制的差异.
- 仅仅扩大保险覆盖范围可能无法完全解决某些人群的低血糖控制问题.
- 了解持续存在的差异对于制定有针对性的干预措施至关重要.
研究的目的:
- 描述美国糖尿病保险成年人血糖控制中的种族和种族差异.
- 评估社会,医疗保健和行为/健康状况因素对这些差异的影响.
- 评估15年期间不同保险类型之间是否存在差异.
主要方法:
- 使用国家健康和营养检查调查数据 (2003-2018) 进行的横截面研究.
- 包括25-80岁的西班牙裔/拉丁裔,非西班牙裔黑人和非西班牙裔白人成年人,患有糖尿病和保险.
- 血糖控制不佳,定义为HbA1c≥7.0%. 分析了社会,医疗和行为因素.
主要成果:
- 与非西班牙裔白人成年人相比,西班牙裔/拉丁裔和非西班牙裔黑人成年人的血糖控制不佳的几率更高.
- 社会因素,特别是粮食安全,显示出差距的减弱.
- 医疗保健和行为/健康状况因素增加了差异,甚至在私人保险人群中也存在.
结论:
- 血糖控制不良的种族和民族差异在美国糖尿病保险成年人中仍然存在.
- 调整社会,医疗保健和行为因素并没有消除这些差异.
- 需要进一步的研究,以确定在获得护理的人群中充分控制血糖的障碍.
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