基于地点的机会,以及在幼儿时代的儿童访问出席
Jordan Tyris1, Diane L Putnick2, Kavita Parikh3
1Division of Hospital Medicine, Children's National Hospital (J Tyris and K Parikh), Washington, DC; Department of Pediatrics, George Washington University School of Medicine and Health Sciences (J Tyris and K Parikh), Washington, DC; Epidemiology Branch (J Tyris, DL Putnick, and EH Yeung), Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Md.
机会较低的社区的孩子参加的健康儿童访问较少. 解决这些儿童获得医疗保健的障碍对于公平的幼儿护理至关重要.
科学领域:
- 儿科健康 儿科健康
- 健康的社会决定因素
- 健康 公平 卫生 公平
背景情况:
- 通过儿童机会指数 (COI) 衡量的较低邻里机会与增加的儿科发病率有关.
- 对COI与纵向健康儿童护理出勤之间的关联不太了解.
- 这项研究研究了COI和健康儿童访问 (WCV) 从出生到36个月以下的出席率之间的关系.
研究的目的:
- 评估儿童机会指数 (COI) 与幼儿时代健康儿童访问 (WCV) 参与度之间的关联.
- 确定邻里机会是否影响遵守推的儿科预防护理计划.
- 根据COI测量的社会经济因素,确定医疗保健获取方面的潜在差异.
主要方法:
- 使用了基于人口的Upperstate KIDS出生队列 (2008-2010年出生在纽约的儿童).
- 将孩子的出生地址与2010年人口普查路径儿童机会指数 (COI) 得分 (非常低至非常高) 联系起来.
- 每4-6个月通过家长问卷收集WCV出席数据,评估从出生到<36个月的访问.
主要成果:
- 在非常低 (aOR 0.68) 和低 (aOR 0.81) COI 社区的儿童,与非常高的COI相比,参加任何WCV的几率显著降低.
- 调整后的 WCV 出席率的平均比例在非常低 (0.45),低 (0.53),中度 (0.53) 和高 (0.54) 的COI水平相比非常高 (0.56) 较低.
- 21%的队列经历了非常低或低的COI,突出了受较低机会影响的大量人口.
结论:
- 出生时的较低邻居机会与幼儿时期健康儿童访问出席率的减少显著相关.
- 研究结果表明,社会经济因素会影响儿童获得和使用基本的儿科预防护理.
- 为了促进健康公平,需要采取旨在减少COI较低地区儿童获得医疗保健的障碍的干预措施.
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