腹腔大动脉瘤破裂发生率的社会经济决定因素:全国地理空间研究
Andrew J Kindon1, Elena Moltchanova2, Oliver T Lyons3
1GeoHealth Laboratory, University of Canterbury, Christchurch, Canterbury, New Zealand; Christchurch Vascular Group, Christchurch, Canterbury, New Zealand; Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand.
概括
腹腔大动脉瘤 (AAA) 破裂热点在新西兰地理上集中,特别是在贫困和毛利社区. 这些发现突显了健康不平等,并为有针对性的AAA查和预防策略提供了信息.
科学领域:
- 血管外科 血管外科
- 公共卫生 公共卫生
- 地理空间流行病学
背景情况:
- 社会经济因素对腹腔大动脉动脉瘤 (AAA) 破裂风险的影响在地理上尚不清楚.
- 针对AAA查和治疗的有针对性的资源配置需要地理空间洞察力.
- 了解这些差异对于公平的医疗保健服务至关重要.
研究的目的:
- 在新西兰阿托亚罗亚新西兰绘制AAA断裂的全国地理空间分布.
- 分析AAA断裂发生率与社会经济因素之间的关联.
- 为有针对性的AAA预防工作确定高风险社区.
主要方法:
- 使用死亡率和住院数据,对AAA断裂 (2000-2019年) 进行全国范围的回顾性地理空间分析.
- 基于贫困,种族和城市可访问性的标准化发病率 (SIR) 的计算.
- 贝叶斯式Poisson回归建模用于估计小区域级AAA断裂发生率,并评估与吸烟率,毛利人口比例,城市可访问性和社会经济贫困 (SED) 的关联.
主要成果:
- 超过5942个AAA断裂被确定,高发病率聚集在持久的热点中.
- 社会经济贫困 (SED) 和吸烟率与AAA破裂发生率的增加有显著的关联.
- 在社会经济贫困,毛利和农村社区观察到较高的SIR,这表明健康差异很大.
结论:
- 在新西兰阿托亚罗亚的持续高风险社区中,AAA断裂发生率表现出显著的地理聚类.
- 高贫困和毛利人群承担了AAA破裂的不成比例的负担,反映了历史上的健康不平等.
- 这些发现需要战略管理和实施AAA查和治疗计划,以解决发现的差异.
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