种族和种族差异:我们所有人的研究计划的见解
medRxiv : the preprint server for health sciences
|September 5, 2025
概括
低水平的他类药物对心血管健康有影响, 影响不同种族和族群的独特障碍. 针对健康的社会决定因素的定制干预措施对于公平预防心血管疾病至关重要.
科学领域:
- 公共卫生
- 心血管医学
- 健康差异研究
背景情况:
- 对于控制心血管疾病 (CVD) 和改善患者的治疗结果而言,静止剂的坚持至关重要.
- 现有的心血管疾病结果差异凸显出需要了解影响不同人群服药的因素.
- 社会人口因素和健康的社会决定因素 (SDoH) 越来越多地被认为是健康不平等的主要驱动因素.
研究的目的:
- 研究不同种族和族裔群体中社会人口因素与服用他类药物的关系.
- 确定不同种族和族裔小组内对他类药物的特殊障碍.
- 帮助制定有针对性的干预措施,以改善人群服用他类药物,减少心血管疾病的差异.
主要方法:
- 对我们所有人 (AoU) 队列数据的回顾性分析,包括社会人口统计信息,处方记录和调查答复 (人口统计,药物暴露,医疗保健利用调查 - HUS).
- 计算百分比覆盖日 (PDC) 以测量他类药物的坚持,充足的坚持定义为PDC≥80%.
- 用多变量逻辑回归模型来评估社会人口统计学因素对他类药物坚持的影响,按种族和种族分层.
主要成果:
- 总共分析了17029名服用他类药物的参与者;他类药物的平均PDC为57%,其中66%的PDC不充分遵守 (PDC≤80%).
- 观察到显著的种族和种族差异:非西班牙裔白人 (NHW) 参与者的PDC中位数为74%,非西班牙裔黑人 (NHB) 参与者为49%,西班牙裔参与者为25%.
- 具体障碍包括NHW的就业问题和提供者无法访问;NHB的患者焦虑和财务限制;以及西班牙裔参与者的患者焦虑和移民地位.
结论:
- 社会人口结构因素和SDoH显著影响他类药物的使用,而独特的障碍影响着不同的种族和民族群体.
- 解决就业,财务限制,患者焦虑,提供医疗服务的机会和移民身份等具体障碍对于改善他类药物使用情况至关重要.
- 需要有针对性的,文化敏感的干预措施来弥合坚守差距,减少心血管疾病的差异,并促进所有人群的平等健康结果.
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