糖尿病的社会和医学决定因素:一个时间受限的多个调解器分析
Farrokh Alemi1, Kyung Hee Lee2, Jee Vang1
1Health Administration and Policy, George Mason University, Fairfax, USA.
Cureus
|October 31, 2023
概括
贫困和获得健康食品的限制等社会决定因素间接地增加了糖尿病患病率. 肥胖和不活动等生活方式因素直接影响美国各县的糖尿病率.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康差异 在健康上的差异
背景情况:
- 研究表明,健康和肥胖/糖尿病的社会决定因素之间存在联系,但因果关系尚不清楚.
- 了解直接和间接途径对于公共卫生干预至关重要.
研究的目的:
- 调查社会,环境和医疗因素是否因果关系地影响人口水平糖尿病患病率.
- 区分对糖尿病发病率的直接和间接影响,控制相互作用.
主要方法:
- 利用来自3,109个美国县的数据,将2017年糖尿病患病率作为依赖变量.
- 雇佣网络多重调解分析,包括最小绝对收缩和选择运营商 (LASSO) 回归.
- 确定了糖尿病的直接决定因素 (2016年数据) 和间接/中介原因 (2015年数据).
主要成果:
- 肥胖,非洲裔美国人人口,身体不活动,健康状况不佳和糖尿病病史解释了2017年63%的糖尿病变异.
- 这些直接预测因素调解了西班牙裔种族,身体困难,吸烟,儿童贫困,健康食品获取有限和低收入等间接因素的影响.
- 2016年肥胖,不活动和健康状况不佳的较高水平预测了2017年糖尿病率的增加.
结论:
- 糖尿病的直接预测因素,除了非洲裔美国人人口百分比外,是生活方式影响的医疗条件.
- 疾病的社会决定因素 (低收入,儿童贫困,健康食品获取有限) 间接地提高了糖尿病患病率.
- 这些发现突出了社会因素,生活方式和糖尿病结果之间的复杂相互作用.
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