Krieger Nancy, Chen Jarvis T, Waterman Pamela D, Rehkopf David H, Subramanian S V
Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
Am J Public Health. 2003 Oct;93(10):1655-71. doi: 10.2105/ajph.93.10.1655.
Use of multilevel frameworks and area-based socioeconomic measures (ABSMs) for public health monitoring can potentially overcome the absence of socioeconomic data in most US public health surveillance systems. To assess whether ABSMs can meaningfully be used for diverse race/ethnicity-gender groups, we geocoded and linked public health surveillance data from Massachusetts and Rhode Island to 1990 block group, tract, and zip code ABSMs. Outcomes comprised death, birth, cancer incidence, tuberculosis, sexually transmitted infections, childhood lead poisoning, and nonfatal weapons-related injuries. Among White, Black, and Hispanic women and men, measures of economic deprivation (e.g., percentage below poverty) were most sensitive to expected socioeconomic gradients in health, with the most consistent results and maximal geocoding linkage evident for tract-level analyses.
使用多层次框架和基于区域的社会经济指标(ABSMs)进行公共卫生监测,有可能克服美国大多数公共卫生监测系统中社会经济数据缺失的问题。为了评估ABSMs是否能够有意义地用于不同种族/族裔 - 性别的群体,我们对来自马萨诸塞州和罗德岛的公共卫生监测数据进行地理编码,并将其与1990年的街区组、普查区和邮政编码ABSMs相链接。结果包括死亡、出生、癌症发病率、结核病、性传播感染、儿童铅中毒以及与武器相关的非致命伤害。在白人、黑人和西班牙裔女性及男性中,经济剥夺指标(如贫困率)对健康方面预期的社会经济梯度最为敏感,在普查区层面的分析中结果最为一致且地理编码链接最为明显。