Andresen E M, Prince-Caldwell A, Akinci F, Brownson C A, Hagglund K, Jackson-Thompson J, Crocker R
Department of Community Health, Saint Louis University School of Public Health, MO 63108, USA.
Am J Prev Med. 1999 Apr;16(3 Suppl):63-71. doi: 10.1016/s0749-3797(98)00151-2.
Estimates of disability in this country are as high as 20%. State health departments need to provide the core activities to deal with this public health problem including assessment, policy development, and assurance. A collaboration among academic institutions and the Missouri Department of Health (MDOH) is a model for providing this core.
A disability workgroup was established among bureaus of the MDOH and three universities. This group selected the disability domain of mobility impairments for initial work. Existing data from the Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) in Missouri and data from the 1990 Census were analyzed. Dissemination of the findings involved community and consumer participation via an advisory group and a public health-sponsored conference on disability. In addition, new data collection efforts are underway using the BRFSS. Education and training activities include both public health students and public health practitioners in learning the content and methodology associated with disability epidemiology.
Data analyses have identified rural geographic areas of the State with high levels of disability and a trend of increasing work disability since 1993. A selected key condition, arthritis, has been confirmed as having a high prevalence (28%) in Missouri. These data also demonstrate that there is a strong risk of limitations associated with arthritis [adjusted odds ratio (OR) 3.57; 95% confidence intervals 3.0, 4.2]. These results will be applied to program planning.
The Missouri program is succeeding in providing both academic and public health practice partners with a productive experience that meets the needs of each.
该国的残疾估计率高达20%。州卫生部门需要开展核心活动来应对这一公共卫生问题，包括评估、政策制定和保障。学术机构与密苏里州卫生部（MDOH）之间的合作是提供这一核心内容的典范。
在MDOH的各部门与三所大学之间成立了一个残疾问题工作组。该小组选择行动障碍的残疾领域作为初步工作内容。分析了来自疾病控制与预防中心（CDC）密苏里州行为风险因素监测系统（BRFSS）的现有数据以及1990年人口普查的数据。研究结果的传播包括通过一个咨询小组以及一次由公共卫生部门主办的残疾问题会议让社区和消费者参与进来。此外，正在利用BRFSS开展新的数据收集工作。教育和培训活动包括让公共卫生专业的学生和公共卫生从业者学习与残疾流行病学相关的内容和方法。
数据分析确定了该州农村地区残疾水平较高，且自1993年以来工作残疾呈上升趋势。选定的一个关键病症——关节炎，已被证实在密苏里州患病率很高（28%）。这些数据还表明，患关节炎导致身体受限的风险很大[调整后的优势比（OR）为3.57；95%置信区间为3.0至4.2]。这些结果将应用于项目规划。
密苏里州的项目成功地为学术和公共卫生实践伙伴提供了一次满足各方需求的富有成效的经历。
