Jacobs David H, Tovar Juan M, Hung Oliver L, Kim Mimi, Ye Philip, Chiang William K, Goldfrank Lewis R
Department of Emergency Medicine, Bellevue Hospital Center/New York University Medical Center, New York, NY 10016, USA.
Acad Emerg Med. 2002 Jun;9(6):599-608. doi: 10.1111/j.1553-2712.2002.tb02297.x.
To compare the demographic profiles, behavioral risk factors, and preventive health care practices of adult immigrant and non-immigrant patients while considering the effects of various socioeconomic variables.
This was a prospective survey administered at a large urban emergency department in New York City. Study subjects were adult immigrant patients presenting in an eight-week period in 1998. One non-immigrant control patient was recruited concurrently with every two immigrant patients. Differences between immigrants and non-immigrants were evaluated using the chi-square test. Multivariate logistic regression models were used to adjust for confounding variables.
Eight hundred sixty-nine immigrant patients from 80 countries and 354 non-immigrant patients completed surveys. Immigrants were more likely not to have reached high school (28.9% vs 8.5%; p < 0.001), to have annual family incomes less than $20,000 (73.8% vs 64.5%; p < 0.01), and to have no health coverage (51.7% vs 30.8%; p < 0.001). Immigrant women were more likely never to have had a Papanicolaou test (16.1% vs 1.4%; OR 11.24, 95% CI = 2.70 to 46.8) and never to have performed a self-breast examination (20.8% vs 7.5%; OR 2.03, 95% CI = 1.29 to 3.20). Immigrants were more likely not to use condoms (63.4% vs 42.8%; OR 1.61, 95% CI = 1.20 to 2.15) and never to have visited a dentist (21.2% vs 7.8; OR 2.54, 95% CI = 1.60 to 4.04). Immigrants were more likely never to have received a purified protein derivative (PPD) skin test (30.3% vs 9.1%; OR 3.85, 95% CI = 2.56 to 5.80) and never to have received a tetanus immunization (48.1% vs 13.5%; OR 3.09, 95% CI = 2.17 to 4.42). These differences were independent of age, gender, marital status, employment, education, income, and health insurance status. When analyzing the immigrant group alone, region of origin, length of time in the United States, and English ability were significant independent predictors of higher-risk behavioral profiles and poor preventive health care practices.
Differences exist between the socioeconomic profiles, behavioral risk profiles, and preventive health care practices of immigrant and non-immigrant patients presenting to a large inner-city municipal emergency department. Different populations within a heterogeneous group of immigrants have distinct health risks and public health needs.
比较成年移民患者和非移民患者的人口统计学特征、行为危险因素及预防性医疗保健行为，同时考虑各种社会经济变量的影响。
这是一项在纽约市一家大型城市急诊科进行的前瞻性调查。研究对象为1998年为期八周内就诊的成年移民患者。每招募两名移民患者，同时招募一名非移民对照患者。采用卡方检验评估移民和非移民之间的差异。使用多变量逻辑回归模型对混杂变量进行调整。
来自80个国家的869名移民患者和354名非移民患者完成了调查。移民更有可能未达到高中教育水平（28.9%对8.5%；p<0.001），家庭年收入低于20,000美元（73.8%对64.5%；p<0.01），且没有医疗保险（51.7%对30.8%；p<0.001）。移民女性更有可能从未进行过巴氏试验（16.1%对1.4%；OR 11.24，95%CI = 2.70至46.8），且从未进行过自我乳房检查（20.8%对7.5%；OR 2.03，95%CI = 1.29至3.20）。移民更有可能不使用避孕套（63.4%对42.8%；OR 1.61，95%CI = 1.20至2.15），且从未看过牙医（21.2%对7.8%；OR 2.54，95%CI = 1.60至4.04）。移民更有可能从未接受过结核菌素皮肤试验（30.3%对9.1%；OR 3.85，95%CI = 2.56至5.80），且从未接受过破伤风免疫接种（48.1%对13.5%；OR 3.09，95%CI = 2.17至4.42）。这些差异与年龄、性别、婚姻状况、就业、教育、收入和医疗保险状况无关。单独分析移民群体时，原籍地区、在美国的居住时间和英语能力是高风险行为特征和不良预防性医疗保健行为的重要独立预测因素。
到大型市中心市政急诊科就诊的移民患者和非移民患者在社会经济特征、行为风险特征和预防性医疗保健行为方面存在差异。异质移民群体中的不同人群有不同的健康风险和公共卫生需求。
