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红线对华盛顿州可查癌症的存活率的持续影响,2000-2018年
Solmaz Amiri1, Anthippy Petras2, Dedra Buchwald3
1Elson S. Floyd College of Medicine, Washington State University, Seattle, WA, USA. solmaz.amiri@wsu.edu.
概括
历史红线 (HOLC等级) 影响现代癌症生存率. 评分为D (红线) 和C的社区显示乳腺癌,结直肠癌和肺癌的死亡率较高,突出显示住房不平等.
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:
- 房屋所有者贷款公司 (HOLC) 历来根据抵押贷款安全性对社区进行了分级,影响了住宅模式.
- 这些历史性的红线实践可能会对社区健康结果产生持久的影响.
- 了解历史上的社区撤资与当代健康之间的联系对于解决健康差异至关重要.
研究的目的:
- 调查1930年代HOLC红线等级与可查癌症的当前生存率之间的关联.
- 分析华盛顿州乳腺癌,宫癌,结肠直肠癌和肺癌的HOLC等级 (A-D) 的生存差异.
- 确定影响癌症死亡率的潜在住房不平等.
主要方法:
- 利用华盛顿州癌症登记处2000-2018年乳腺,宫,结肠直肠和肺癌患者的数据.
- 采用卡普兰-梅尔和考克斯的比例危险回归来分析所有原因和癌症特定死亡率.
- 与HOLC等级相关的检查的生存结果:A (最佳),B (仍然可取),C (下降) 和D (红线).
主要成果:
- 在乳腺癌患者的HOLC等级D和C区域观察到较高的全因死亡危险比率.
- 在C级和D级地区的结肠直肠癌和肺癌患者表现出更高的全因死亡风险比率.
- HOLC等级与宫癌患者的生存结果没有显著关联.
结论:
- 历史红线 (HOLC等级) 与癌症存活率的当代差异有关,特别是乳腺癌,结肠直肠癌和肺癌.
- 这些发现强调了住宅隔离和剥离对健康结果的持续影响.
- 需要采取干预措施来解决与住宅位置和历史歧视性做法相关的未被承认的健康不平等问题.
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