Brown D W, Giles W H, Greenlund K J, Croft J B
Cardiovascular Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia 30341, USA.
Prev Med. 2001 Dec;33(6):517-22. doi: 10.1006/pmed.2001.0928.
The objective of this study was to determine whether the Year 2000 national health objective for cholesterol screening was attained and to identify disparities in cholesterol screening across racial or ethnic and socioeconomic groups.
Using data from 149,692 persons interviewed by the 1999 Behavioral Risk Factor Surveillance System, we estimated the proportion of adults age > or =20 years who were screened for high blood cholesterol within the preceding 5 years.
Overall, an estimated 70.8% of the U.S. population was screened for cholesterol, falling short of the Year 2000 objective of 75%. Screening prevalence was lowest at ages 20-44 years (58.2%), in contrast to ages 45-64 years (81.9%) and > or =65 years (87.1%). Screening prevalence was also low among Asian or Pacific Islanders (62.7%) and Hispanics (60.7%), particularly Hispanic men (55.3%). After multivariate adjustment, Asian Pacific Islanders were significantly less likely to be screened compared with white non-Hispanics (OR = 0.76, 95% CI 0.65, 0.89). The likelihood of screening decreased with decreasing income level (P < 0.05) and persons with health insurance were 1.6 times more likely to have been screened during the past 5 years than adults with no insurance (P < 0.05).
Significant disparities in cholesterol screening exist across age, gender, racial or ethnic, and socioeconomic groups in the United States. As we look to attain the objectives of Healthy People 2010, state and local health officials and policy makers should be aware of these disparities in order to design and target effective cholesterol screening programs and cardiovascular disease prevention programs to those most in need.
本研究的目的是确定是否实现了2000年全国胆固醇筛查的健康目标，并识别不同种族或族裔以及社会经济群体在胆固醇筛查方面的差异。
利用1999年行为危险因素监测系统对149,692人进行访谈的数据，我们估计了年龄≥20岁的成年人在过去5年内接受高血胆固醇筛查的比例。
总体而言，估计美国70.8%的人口接受了胆固醇筛查，未达到2000年75%的目标。筛查患病率在20 - 44岁年龄段最低（58.2%），而45 - 64岁年龄段为81.9%，≥65岁年龄段为87.1%。亚洲或太平洋岛民（62.7%）和西班牙裔（60.7%）的筛查患病率也较低，尤其是西班牙裔男性（55.3%）。经过多变量调整后，与非西班牙裔白人相比，亚太岛民接受筛查的可能性显著降低（比值比 = 0.76，95%可信区间0.65，0.89）。筛查的可能性随着收入水平的降低而降低（P < 0.05），并且有医疗保险的人在过去5年内接受筛查的可能性是没有保险的成年人的1.6倍（P < 0.05）。
在美国，年龄、性别、种族或族裔以及社会经济群体在胆固醇筛查方面存在显著差异。在我们努力实现《健康人民2010》的目标时，州和地方卫生官员及政策制定者应意识到这些差异，以便为最需要的人群设计并实施有效的胆固醇筛查项目和心血管疾病预防项目。
