加利福尼亚州的死亡率和健康地点指数
Neil Maizlish1, Adrienne Damicis1
1Public Health Alliance of Southern California.
American journal of epidemiology
|November 15, 2024
概括
较高的社区健康评分与加利福尼亚州较低的死亡率有关,包括COVID-19. 这突显了健康的社会决定因素对人口健康结果的影响.
科学领域:
- 公共卫生和流行病学
- 健康的社会决定因素
- 健康 公平 研究 健康 公平 研究
背景情况:
- 健康的社会决定因素显著影响人口健康结果.
- 健康场所指数 (HPI) 是一个综合测量,评估多个领域的社区状况.
- 了解社区特征与死亡率之间的关系对于公共卫生干预至关重要.
研究的目的:
- 研究通过HPI测量的社区社会经济条件与加利福尼亚州的死亡率之间的关联.
- 检查HPI分值和因各种原因的死亡率之间的剂量反应关系,包括COVID-19.
- 评估改善社区条件对减少健康不平等的潜在影响.
主要方法:
- 利用了加利福尼亚州的死亡证明数据 (2015-2021) 和美国社区调查人口数据 (2015-2019).
- 汇总的死亡数据到人口普查管道水平,并按HPI分值,年龄,性别和种族/种族分层.
- 根据年龄调整的就业率,用于剂量反应分析的细分回归,以及计算的人口归因分数.
主要成果:
- 在HPI分值和所有原因的死亡率,癌症,心血管疾病,COVID-19,糖尿病,肝硬化,伤害和阿尔茨海默病之间观察到的逆关系.
- 最低和最高HPI分值之间的所有原因死亡率比率为1.63;对于COVID-19,它是7.61.
- 对于所有原因的死亡率,人口可归因的比例为24%,而对于COVID-19,它是72%,表明邻里因素的实质性影响.
结论:
- 根据HPI测量,社区状况与加利福尼亚州的死亡率差异密切相关.
- 存在显著的健康不平等,较低的HPI得分与较高的死亡率有关,特别是在COVID-19中.
- 研究结果支持将基于地区的社会经济措施纳入公共卫生监督和政策,以减少健康不平等.
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