Shi L, Starfield B
Department of Health Policy and Management, Johns Hopkins School of Public Health and Hygiene, 624 N Broadway, Room 409, Baltimore, MD 21205-1996, USA.
Am J Public Health. 2001 Aug;91(8):1246-50. doi: 10.2105/ajph.91.8.1246.
This study assessed whether income inequality and primary care physician supply have a different effect on mortality among Blacks compared with Whites.
We conducted a multivariate ecologic analysis of 1990 data from 273 US metropolitan areas.
Both income inequality and primary care physician supply were significantly associated with White mortality (P < .01). After the inclusion of the socioeconomic status covariates, the effect of income inequality on Black mortality remained significant (P < .01), but the effect of primary care physician supply was no longer significant (P > .10), particularly in areas with high income inequality.
Improvement in population health requires addressing socioeconomic determinants of health, including income inequality and primary care availability and access.
本研究评估了收入不平等和初级保健医生供给对黑人死亡率的影响是否与白人不同。
我们对来自美国273个大都市地区的1990年数据进行了多变量生态分析。
收入不平等和初级保健医生供给均与白人死亡率显著相关（P < 0.01）。纳入社会经济地位协变量后，收入不平等对黑人死亡率的影响仍然显著（P < 0.01），但初级保健医生供给的影响不再显著（P > 0.10），尤其是在收入不平等程度高的地区。
改善人群健康状况需要解决健康的社会经济决定因素，包括收入不平等以及初级保健的可及性和可获得性。
