Hawker Jeremy I, Olowokure Babatunde, Sufi Farzana, Weinberg Julius, Gill Noel, Wilson Richard C
Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Respir Med. 2003 Nov;97(11):1219-24. doi: 10.1016/s0954-6111(03)00252-x.
To examine the relationship between social deprivation and risk of hospital admission for respiratory infection.
Ecological study using hospital episode statistics and population census data. Cases were residents of the West Midlands Health Region admitted to hospital with a diagnosis of respiratory infection, acute respiratory infection, pneumonia or influenza over a 5-year period. Postcodes of cases were used to assign Townsend deprivation scores; these were then ranked and divided into five deprivation categories. Poisson regression analysis was used to estimate the magnitude of effect for associations between deprivation category and hospital admission by age and admitting diagnosis.
There were 136755 admissions for respiratory infection, equivalent to an annual admission rate of 27.1 per 1000 population (95% CI = 26.9-27.2). Deprivation was associated with increased admission rates for all respiratory infection (P < 0.0001) and affected all age-groups. The greatest effect was in the 0-4 years age-group with admission rates 91% higher in the most deprived children compared to the least deprived. Hospital admissions for acute respiratory infection and pneumonia were both significantly associated with deprivation (P < 0.0001).
Respiratory infection is associated with social inequalities in all age-groups, particularly in children. Prevention of respiratory infection could make an important contribution to reducing health inequalities.
探讨社会剥夺与呼吸道感染住院风险之间的关系。
采用医院病历统计数据和人口普查数据进行生态学研究。研究对象为西米德兰兹郡健康区域的居民，这些居民在5年期间因呼吸道感染、急性呼吸道感染、肺炎或流感而住院。通过病例的邮政编码来确定汤森德剥夺分数；然后对这些分数进行排名，并分为五个剥夺类别。采用泊松回归分析来估计不同剥夺类别与按年龄和入院诊断划分的住院之间关联的效应大小。
呼吸道感染住院病例有136755例，相当于年住院率为每1000人中有27.1例（95%置信区间 = 26.9 - 27.2）。社会剥夺与所有呼吸道感染的住院率增加相关（P < 0.0001），且影响所有年龄组。影响最大的是0 - 4岁年龄组，最贫困儿童的住院率比最不贫困儿童高91%。急性呼吸道感染和肺炎的住院均与社会剥夺显著相关（P < 0.0001）。
呼吸道感染与所有年龄组的社会不平等相关，尤其是儿童。预防呼吸道感染对减少健康不平等可能有重要贡献。
