解释美国印第安人和阿拉斯加原住民中COVID-19相关死亡率的差异
Wendy S Slutske1,2, Karen L Conner3, Julie A Kirsch1,2
1Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
美国印第安人和阿拉斯加土著 (AI/AN) 个人面临更高的COVID-19死亡率. 虽然并发症和社会经济因素解释了一些差异,但未测量的因素仍然有助于这种严重的健康不平等.
科学领域:
- 公共卫生 公共卫生
- 健康差距 研究 研究 研究 研究
- 流行病学 流行病学
背景情况:
- 美国印第安人和阿拉斯加原住民 (AI/AN) 人口经历了不成比例的高COVID-19死亡率.
- 有限的经验数据可以解释这种健康不平等的根本原因.
研究的目的:
- 调查医疗相关疾病,社会经济贫困或治疗机会是否解释了AI/AN个人中COVID-19死亡率的升高.
- 为了比较AI/AN和非西班牙裔白人 (NHW) 住院患者群体之间的COVID-19死亡率.
主要方法:
- 使用协调的电子健康记录数据进行回顾性队列研究.
- 包括所有来自21个美国卫生系统的COVID-19住院患者 (2020年2月 - 2022年1月).
- 对AI/AN和匹配的NHW住院患者之间的死亡率进行比较分析.
主要成果:
- 与NHW住院患者 (7.1%) 相比,AI/AN住院患者的住院死亡率 (13.2%) 较高,未调整的几率比率 (OR) 为1.98.
- 在调整了相关疾病,社会经济贫困和治疗机会后,AI/AN状态和死亡率之间的关联减少了 (OR 1.59).
- 在AI/AN族裔与死亡率之间仍然存在显著的残留关联,这表明了其他未测量的因素.
结论:
- 虽然医疗并发症,社会经济因素和治疗机会部分解释了AI/AN人群中COVID-19死亡率差异,但它们并不能完全解释观察到的不平等.
- 未测量的因素在AI/AN个体经历的较高的COVID-19死亡率中起着至关重要的作用.
- 进一步的研究是必要的,以确定和解决这些剩余的健康差异的贡献者.
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