不平等的沙漠:社会脆弱性在产妇护理差距中的作用
Angelo Cadiente1, Jamie Chen2, Bryan Pilkington3
1Health Ethics Lab, Hackensack Meridian School of Medicine, Nutley, NJ, USA; Department of Obstetrics & Gynecology, Maimonides Medical Center, Brooklyn, NY, USA.
Midwifery
|September 24, 2025
概括
社会脆弱性会影响获得产妇护理的机会,社会经济因素与提供者数量减少和无保险人数增加有关. 解决系统性障碍对于在服务不足的地区公平分配资源至关重要.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 产妇护理沙漠对母亲和婴儿的健康结果构成重大风险.
- 社会脆弱性越来越被认为是影响医疗保健获取和质量的关键因素.
研究的目的:
- 调查社会脆弱性和产妇护理缺失的普遍性之间的复杂关系.
- 确定与有限获得产科护理相关的社会脆弱性的特定维度.
主要方法:
- 美国1084个县的分析,使用Dimes月份数据 (2019-2021) 和CDC/ATSDR社会脆弱性指数 (SVI, 2020).
- 我们使用线性回归模型来检查SVI,产科服务提供者的可用性和未保险妇女的比例之间的关联.
主要成果:
- 总体而言,SVI并没有显著地预测产科护理的沙漠分类.
- 较高的SVI分数与更少的产科提供者和增加的无保险率有关.
- 具体的SVI组件显示了各种各样的关联:社会经济脆弱性和家庭特征与减少访问相关,而种族/少数民族地位和交通/住房因素与更大的访问有悖论的联系.
结论:
- 具有高度社会经济和家庭脆弱性的县面临着社会风险和有限的产妇护理基础设施的双重挑战.
- 尽管存在潜在的差异,但某些弱势群体 (种族/族裔少数群体,交通障碍者) 可能更容易获得可用的医疗资源.
- 有效的战略必须解决系统性障碍,并促进产妇护理资源的公平分配,而不仅仅是简单的可用性.
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