在黑人和西班牙裔中风患者中,感知歧视和SDOH之间的分离
Randolph Marshall1,2, Eduard Valdes3, Michelle Corkrum4
1Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA. rsm2@columbia.edu.
Journal of racial and ethnic health disparities
|March 4, 2026
概括
黑人中风幸存者经历的种族歧视 (PRD) 比西班牙裔和白人幸存者要高得多,尽管有类似的健康社会决定因素 (SDOH) 障碍. 解决PRD对于减少中风差异至关重要.
科学领域:
- 健康差异 在健康上的差异
- 脑卒中神经学 脑卒中神经学
- 健康的社会决定因素
背景情况:
- 结构性种族主义有助于社会健康决定因素 (SDOH) 障碍和少数群体社区的种族歧视 (PRD).
- 在黑人和西班牙裔中风幸存者中,SDOH和PRD之间的相互作用仍未得到充分研究.
- 了解这些关系对于开发有效的中风差异干预措施至关重要.
研究的目的:
- 评估黑人,西班牙裔和白人中风幸存者中SDOH障碍物和PRD的流行率.
- 调查这些群体中SDOH和PRD之间的关系.
- 为了确定PRD是否在种族-种族群体之间存在差异,独立于SDOH.
主要方法:
- 从一个城市三级护理中心对67名中风幸存者 (38名黑人,17名西班牙裔,12名白人) 的截面分析.
- 使用适应的PhenX工具评估所感知的歧视.
- 通过修改的PhenX调查,在五个领域 (教育,经济稳定,医疗保健,社区,社会支持) 评估了SDOH.
- 采用ANOVA和多变量线性回归,对共变量进行调整.
主要成果:
- 在黑人和西班牙裔参与者中,≥3个SDOH障碍的患病率相似,在白人参与者中更低.
- 与西班牙裔 (平均值=4.4) 和白人 (平均值=3.3) 参与者相比,黑人参与者报告了显著更高的PRD得分 (平均值=10.4).
- 多变量分析证实,黑人参与者的PRD明显高于西班牙裔和白人参与者 (P<0.02).
- 在西班牙裔参与者中,邻里处于不利地位更为普遍 (P=0.0202).
结论:
- 在少数派中风幸存者中,PRD和SDOH负担之间存在分离.
- 黑人中风幸存者报告的PRD明显高于西班牙裔幸存者,尽管SDOH负担相似.
- 针对PRD独立于SDOH的干预措施可能对于减轻中风结果的种族种族差异至关重要.
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