心血管健康在医疗保险服务费的种族和性别交叉点
Gray Babbs1,2, Kendra Offiaeli1,2, Jaclyn M W Hughto3,4,5
1Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
JAMA health forum
|August 22, 2025
概括
跨性别和性别多样性 (TGD) 的有色人种患心血管疾病的比例更高. 与非西班牙裔白人相比,黑人TGD患者患上外周血管疾病,心力衰竭和糖尿病的患病率增加.
科学领域:
- 心血管健康
- 健康上的差异
- 医疗公平
背景情况:
- 跨性别和性别多样性 (TGD) 个体面临更高的心血管风险.
- 包括黑人和西班牙裔人口在内的少数民族也表现出心血管疾病的高发病率.
- 在TGD人群的种族和民族亚群中,对心血管疾病的研究有限.
研究的目的:
- 在TGD和cisgender个体中比较与心血管相关疾病的流行率.
- 使用量化交叉方法来分析差异.
- 确定不同种族和种族背景的特异性TGD患者的特定心血管疾病.
主要方法:
- 2011-2020年医疗保险入学和索赔数据的分析.
- 使用诊断代码和护理利用算法识别可能的TGD受益者.
- 倾向性匹配比较TGD受益者与10位邻居的性别匹配.
主要成果:
- 与非西班牙裔白人相比,黑人TGD受益者患周围血管疾病 (74%),充血性心力衰竭 (76%) 和糖尿病 (50%) 的患病率显著更高.
- 亚洲和太平洋岛民,黑人和西班牙裔TGD受益者患心血管相关疾病的比例较高.
- 性别,种族和种族的交集导致黑人 (6.3%) 和亚洲和太平洋岛民 (19.9%) 的外周血管疾病患病率过高.
结论:
- 来自亚洲和太平洋岛屿,黑人和西班牙裔的TGD个体患有心血管相关疾病的患病率很高.
- 这些高风险部分归因于性别认同,种族和民族的交集.
- 医疗保险应实施有针对性的干预措施,以支持TGD受益人的心血管健康.
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