社区恢复力和中风结果在老年人:超越农村城市分类
Ruaa Al Juboori1, Emily Welker1, Marie Barnard1,2
1Public Health, School of Applied Sciences, The University of Mississippi, Oxford, MS, United States.
Frontiers in public health
|December 29, 2025
概括
社区的性,特别是社会和基础设施因素,显著减少了老年人中风的负担. 战略必须考虑不同的县轨迹,以解决中风发病率的地理差异.
科学领域:
- 公共卫生 公共卫生
- 老年学是一门学科.
- 农村卫生 农村卫生
背景情况:
- 脑卒中是美国老年人死亡和残疾的主要原因,地理差异仍然存在.
- 社区弹性对中风负担的影响,特别是在不同的农村-城市县轨迹上,尚不清楚.
研究的目的:
- 评估县级弹性领域与65岁及以上的医疗保险受益人中中风负担之间的关联.
- 评估这些协会在稳定的农村,稳定的城市,农村到城市的过渡,以及城市到农村的城市化县之间有何差异.
主要方法:
- 美国大陆3,100个县的生态研究,使用农村-城市连续代码进行轨迹分类.
- 通过社区基础弹性指标 (BRIC) 指数 (社会,经济,社区资本,机构,基础设施,环境领域) 衡量弹性.
- 相关性,多变量回归和空间分析 (空间关联的本地指标 - LISA) 检查了弹性-中风负担联系.
主要成果:
- 平均中风负担为5.5%,并从2014-2022年增加,在城市和城市化县最高.
- 在所有县的轨迹中,社会弹性始终与较低的中风负担相关.
- 基础设施和环境弹性显示反向关联,因轨迹而异;经济和机构弹性显示在一些模型中具有积极的关联.
- 社会性是总体上最强的负面预测因素,也是过渡和城市化县唯一重要的领域.
- 空间分析显示,东南部 (中风带) 的高冲击集群与低弹性域重叠.
结论:
- 社会和基础设施的弹性是对老年人中风负担的关键保护因素.
- 对经济和机构性的积极关联可能反映了上下文或测量因素.
- 冲击带中重叠的低弹性和高冲击集群需要量身定制的,以弹性为基础的战略来缓解地理差异.
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