公共卫生 公共卫生
Yiqi Zhu1, Jean-Francois Trani2,3, Alexis I B Walker1
1Washington University School of Medicine, Saint Louis, MO, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
健康的结构性和社会决定因素 (S/SDOH) 显著影响黑人老年人的情绪障碍和认知障碍. 歧视和困难是关键的驱动因素,强调了与医疗进步并发的社会正义倡议的必要性.
科学领域:
- 老年学是指老年学的学科.
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 与非西班牙裔白人相比,黑人中年和老年人患情绪障碍和认知障碍的风险更高.
- 健康的结构性和社会决定因素 (S/SDOH) 显著影响健康结果,但它们与这种人口群中的情绪障碍的交叉关系尚未得到充分研究.
- 现有的研究经常使用有限或聚合的S/SDOH措施,需要更细致的方法.
研究的目的:
- 为了检查情绪障碍 (抑郁和焦虑),认知障碍和黑人老年人S/SDOH之间的关系.
- 在个人和家庭层面使用基于国家老龄健康差异研究所研究框架的新型S/SDOH措施.
- 为了确定特定的S/SDOH因素,这些因素会导致这种人群中的情绪障碍和认知障碍.
主要方法:
- 分析了大圣路易斯地区45岁以上的312名黑人参与者的基线数据.
- 构建一个S/SDOH复合指数 (S/SDOH-CI) 来评估贫困和风险因素.
- 测量抑郁症 (PHQ-9),焦虑症 (GAD-7) 和认知功能 (MoCA,PACC).
主要成果:
- 剥夺负担增加1个SD与情绪障碍症状的几率增加3.12倍有关.
- 困难/日常压力因素 (17%) 和歧视 (11%) 是情绪障碍的主要原因,超过了教育的影响 (10.67%).
- 种族主义成为健康不平等的重要驱动因素,特别影响黑人男性.
结论:
- 调查结果强调了S/SDOH,特别是歧视和困难在加剧黑人老年人情绪障碍方面的关键作用.
- S/SDOH-CI有效地确定了集团内部的差异和特定的风险/弹性因素.
- 将医学进步与社会正义倡议相结合的综合方法对于解决健康不平等至关重要.
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