Whitman Steven, Silva Abigail, Shah Ami, Ansell David
Sinai Urban Health Institute, Sinai Health System, Chicago, Illinois, USA.
J Med Syst. 2004 Aug;28(4):397-411. doi: 10.1023/b:joms.0000032854.99522.0d.
Small-area analysis in health is essential in uncovering local-level disparities often masked by health estimates for large areas (e.g., cities, counties, states). In this context, 14 health status indicators (HSIs) were examined for six Chicago community areas that reflect the substantial diversity of the city. HSIs were compared over time (from 1989-90 to 1999-2000) and across community areas. Important disparities among these community areas in mortality rates, birth outcomes, and infectious diseases were found. In many cases the disparities were in the expected direction with the richest and predominantly White community area experiencing the lowest rates. However, some surprises did manifest themselves. For example, only the poorest community area experienced a statistically significant decline in the infant mortality rate. Since so much of attention is now being paid to reducing and eliminating these disparities, it is important to examine their existence to better understand how to minimize them.
健康领域的小区域分析对于揭示常被大面积区域(如城市、县、州)健康评估所掩盖的地方层面差异至关重要。在此背景下,我们考察了反映芝加哥市显著多样性的六个社区区域的14项健康状况指标(HSIs)。对HSIs进行了跨时间(从1989 - 90年到1999 - 2000年)和跨社区区域的比较。发现这些社区区域在死亡率、出生结局和传染病方面存在重要差异。在许多情况下,差异符合预期方向,最富裕且主要为白人的社区区域比率最低。然而,也出现了一些意外情况。例如,只有最贫困的社区区域婴儿死亡率出现了统计学上的显著下降。鉴于目前人们如此关注减少和消除这些差异,审视它们的存在对于更好地理解如何将其最小化很重要。