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在南卡罗来纳州医疗中心的剖腹产患病率的空间和种族/民族差异
Jeffrey T Howard1, Sam Lawton2, Dulaney Wilson3
1Department of Public Health, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, 78249, USA. jeffrey.howard@utsa.edu.
Journal of racial and ethnic health disparities
|October 18, 2024
概括
剖腹产的种族差异与社区的社会脆弱性有关. 在考虑了社会脆弱性指数 (SVI) 之后,个人种族并不是剖腹产率的重要因素.
科学领域:
- 公共卫生 公共卫生
- 健康差距 研究 研究 研究 研究
- 社会流行病学 社会流行病学
背景情况:
- 现有的文献强调了剖腹产产率的种族/民族差异.
- 对于个人种族/种族和社区层面的社会脆弱性对剖腹产的综合影响的理解有限.
- 这项研究探讨了社会脆弱性,种族和剖腹产患病率的交叉关系.
研究的目的:
- 检查社会脆弱性,种族人口分布和剖腹产分娩模式之间的关系.
- 调查人口普查系统层面的社会脆弱性指数 (SVI) 对剖腹产率的影响.
- 确定社区层面的社会脆弱性是否解释了在剖腹产中观察到的种族/民族差异.
主要方法:
- 利用来自南卡罗来纳州大型医疗中心 (2019-2020) 的电子医疗记录数据.
- 分析了剖腹产作为结果,共变量包括患者人口统计,临床因素和人口普查通道SVI.
- 采用了多层次二进制物流回归的通用线性混合模型来评估SVI与剖腹产的关联.
主要成果:
- 与非西班牙裔白人母亲相比,非西班牙裔黑人母亲的剖腹产率更高.
- 在对人口普查通道SVI进行控制后,个人种族/民族和剖腹产之间的关联变得无关紧要.
- 对剖腹产发病率,非西班牙裔黑人人口和SVI观察到显著的空间聚类,表明高剖腹产发病率与高SVI和非西班牙裔黑人人口的趋势.
结论:
- 非西班牙裔黑人母亲中剖腹产的可能性更高,可以通过人口普查管道层面的社会脆弱性差异来解释.
- 社区层面的社会脆弱性是调解剖腹产种族差异的一个关键因素.
- 调查结果强调了考虑社会经济和环境因素在了解和解决产科护理差异方面的重要性.
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