国家层面的结构性种族主义和事件 冠心病 冠心病
Monika M Safford1, Tyson Brown2, Joanna Bryan1
1Division of General Internal Medicine Weill Medical College of Cornell University New York NY USA.
Journal of the American Heart Association
|December 30, 2025
概括
结构性种族主义,特别是住宅隔离,与黑人美国人死亡冠心病 (CHD) 的更高率有关. 解决隔离问题可能有助于减少黑人和白人之间的心血管疾病差异.
科学领域:
- 公共卫生 公共卫生
- 社会学 社会学 社会学
- 流行病学 流行病学
背景情况:
- 与白人美国人相比,黑人美国人患冠心病 (CHD) 的负担不成比例.
- 这些健康差异在很大程度上受到社会决定因素和结构性种族主义的影响,但结构性种族主义和事件性心血管疾病之间的直接联系需要进一步调查.
- 这项研究研究了结构性种族主义的验证措施与心脏病发病率之间的关联,假设黑人个体之间的联系更强.
研究的目的:
- 调查结构性种族主义和冠心病 (CHD) 在全国队列中的三项措施之间的关联.
- 确定国家层面的结构性种族主义是否与发生性心血管疾病有关,特别是与白人相比,黑人个人.
主要方法:
- 利用了来自国家REGARDS (中风的地理和种族差异原因) 队列 (n=30,239) 的数据.
- 事件性心脏病被定义为心肌梗塞或死于心脏病,经过专家评判.
- 结构性种族主义是通过贫困和保险状况的黑人:白人比率和住房隔离的不相似度指数 (DI) 来衡量的,并通过种族分层的考克斯比例危险模型进行分析.
主要成果:
- 高不相似度指数 (DI),表明居住种族隔离较大,与黑人参与者 (HR=1.35) 发生致命性心血管疾病有显著的关联,但与白人参与者无关.
- 其他措施,包括黑人:白人贫困百分比和无保险百分比,在任何种族群体中都没有显示出与事件CHD结果的显著关联.
- 结果在不同的人口分组中一致,包括男性和女性,年轻人和老年人.
结论:
- 通过不相似性指数测量的种族住宅隔离与致命冠心病 (CHD) 的发病率增加有关,特别是在黑人中.
- 与其他研究的结构因素不同,住宅隔离成为CHD差异的重要相关因子.
- 旨在减少住宅种族隔离的政策干预可能会减轻黑人与白人在冠状动脉疾病发病率上的差异.
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