Pearcy Jeffrey N, Keppel Kenneth G
State and Local Support Branch, National Center for Health Statistics, Rm. 767, 6525 Belcrest Road, Hyattsville, MD 20782, USA.
Public Health Rep. 2002 May-Jun;117(3):273-80. doi: 10.1093/phr/117.3.273.
Eliminating health disparities is a goal of Healthy People 2010. In order to track progress toward this goal, we need improved methods for measuring disparity. The authors present the Index of Disparity (ID) as a summary measure of disparity.
The ID, a modified coefficient of variation, was used to measure disparity across populations defined on the basis of race/ethnicity, income, education, and gender. Disparity was also assessed for a diverse range of health indicators and over time to monitor trends.
Disparity in cardiovascular disease deaths decreased based on gender from 1989 to 1998 but was largely unchanged based on race/ethnicity. The magnitude of disparities in cervical cancer and cholesterol screening, smoking, exercise, and health insurance ranged from 1.9% to 78.6%. The largest disparities for health indicators were not associated with any particular population classification, whether defined on the basis of race/ethnicity, education, or income.
To eliminate disparities, we need a means to assess disparities across many types of health indicators. Furthermore, for a given health indicator, disparities may differ for populations defined on the basis of race/ethnicity, education, income, and so on. The ID is a simple method for summarizing disparities across groups within a population that can be applied across health indicators regardless of magnitude, over time to monitor trends, and across different populations.
消除健康差异是《健康人民2010》的一个目标。为了追踪朝着这一目标取得的进展,我们需要改进衡量差异的方法。作者提出差异指数(ID)作为差异的一种汇总度量。
差异指数是变异系数的一种修正形式,用于衡量基于种族/民族、收入、教育程度和性别的不同人群之间的差异。还针对一系列不同的健康指标并随时间推移评估差异,以监测趋势。
1989年至1998年期间,基于性别的心血管疾病死亡差异有所下降,但基于种族/民族的差异基本未变。宫颈癌和胆固醇筛查、吸烟、运动及医疗保险方面的差异幅度在1.9%至78.6%之间。健康指标方面最大的差异与任何特定的人群分类均无关联,无论该分类是基于种族/民族、教育程度还是收入。
为了消除差异,我们需要一种方法来评估多种类型健康指标之间的差异。此外,对于某一特定健康指标而言,基于种族/民族、教育程度、收入等所定义的人群之间的差异可能各不相同。差异指数是一种简单的方法,用于汇总人群中不同群体之间的差异,可应用于各种健康指标,无论差异幅度如何,可随时间推移监测趋势,也可用于不同人群。