总社会暴露与事件多病症之间的关联:基于人口的队列研究
Ingrid Giesinger1, Emmalin Buajitti1, Arjumand Siddiqi1,2
1Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada.
经历多种社会劣势会显著增加女性和男性发展多重疾病 (多种慢性疾病) 的风险. 这突显了社会决定因素对长期健康结果的累积影响.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康的社会决定因素
背景情况:
- 多病症,即两个或两个以上的慢性疾病的同时发生,越来越被认为是一个重大的公共卫生挑战.
- 众所周知,健康的社会决定因素 (SDOH) 影响健康结果,包括慢性疾病的发展.
研究的目的:
- 调查多种社会决定因素对多重疾病发病率的综合影响.
- 了解与累积社会劣势和多病症风险相关的社会梯度.
主要方法:
- 利用来自加拿大安大略省的综合链接人口代表性数据.
- 通过总结12-15个社会劣势指标,生成了总社会暴露 (TSE) 的增值和加权增值指标.
- 雇员竞争风险 考克斯比例危险模型,以性别分层分析,以估计多病发病率的危险比率.
主要成果:
- 添加性TSE和加权添加性TSE都与女性和男性多病症风险增加有显著的关联.
- 在多重疾病风险中观察到明显的社会梯度,遇到更大的社会劣势的人具有更高的风险.
- 调整后的模型证实,与社会不利程度较低的人相比,社会不利程度最高的人患多种疾病的风险增加.
结论:
- 健康的多个社会决定因素的累积效应在多病发病率中起着至关重要的作用.
- 调查结果强调了解决社会不平等问题的重要性,以减轻多病症的负担.
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