在加利福尼亚州 (1997-2018) 评估人口普查区农村和严重孕产妇发病率之间的关系
Rachel L Berkowitz1, Peiyi Kan2, Xing Gao3
1Department of Public Health and Recreation, College of Health and Human Sciences, San José State University, San Jose, California, USA.
概括
加利福尼亚州农村人口普查区的分娩人员面临严重孕产妇发病率 (SMM) 的更高风险. 这种风险在微型城市地区最为明显,这凸显了对健康差异的分县级分析的必要性.
科学领域:
- 生殖健康 生殖健康
- 医疗保健服务研究 医疗服务研究
- 农村健康差异 农村健康差异
背景情况:
- 现有研究表明,与城市相比,农村县的个人患重症母病 (SMM) 风险较高.
- 之前的研究没有在细粒度的分县人口普查地带层面上探索农村,限制了对地理差异的细微理解.
研究的目的:
- 调查分县级农村和加利福尼亚州分娩个体中严重孕产妇死亡率 (SMM) 风险之间的关联.
- 为了确定一个更详细的,人口普查地带层面的农村分析是否揭示了与更广泛的县级评估相比,SMM风险的不同模式.
主要方法:
- 利用加利福尼亚州1997年至2018年的出生相关的生命统计和医院出院记录.
- 定义SMM使用21种可能致命的条件和救命程序.
- 使用农村-城市通勤区代码 (分类为2类和4类) 描述人口普查区的农村地区,并采用混合效应的后勤回归模型.
主要成果:
- 在10,091,415个分娩中,有1.1%的人经历了SMM.
- 在农村和城市地区 (2类模型) 的个人中,SMM的风险增加了10%.
- 在微型城市与大都市地区 (四类模型) 发现SMM风险增加了16%,这表明在次县级有显著的关联.
结论:
- 与农村相关的SMM风险增加主要是由于居住在微型城市人口普查区而不是大都市人口普查区.
- 在郊区内资源获取方面的潜在不平等可能导致观察到的差异.
- 强调在分县人口普查地带层面分析农村的重要性至关重要,以准确识别和解决中小企业风险的地理差异.
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