公共卫生对恐怖主义的应对会公平吗？生物恐怖事件期间感知公平方面的种族/族裔差异。

Will public health's response to terrorism be fair? Racial/ethnic variations in perceived fairness during a bioterrorist event.

作者信息

Eisenman David P, Wold Cheryl, Setodji Claude, Hickey Scot, Lee Ben, Stein Bradley D, Long Anna

机构信息

RAND Corporation, Santa Monica, CA 90407-2138, USA.

出版信息

Biosecur Bioterror. 2004;2(3):146-56. doi: 10.1089/bsp.2004.2.146.

DOI:10.1089/bsp.2004.2.146

PMID:15588052

Abstract

OBJECTIVES

Public health departments' effectiveness during catastrophic bioterrorism will require trust on the part of diverse communities. This study describes variations in perceptions that the public health system will respond fairly to one's needs in a bioterrorist event, regardless of race/ethnicity, income, or other characteristics.

METHODS

Using the Los Angeles County Health Survey, a random-digit, population-based, telephone survey, we conducted multivariate logistic regression of race/ethnicity on perceived fairness, adjusting for demographic factors and perceived neighborhood safety. We performed similar analyses stratified by race/ethnicity subgroup.

RESULTS

Overall, 72.7% of respondents perceived that the public health system will respond fairly in a bioterrorist event. African Americans (AA) and Asian/Pacific Islanders (API) reported the lowest perceived fairness (AA 63.0%, API 68.2%, Latino 73.1%, White 76.6%, p = 0.005 for group differences). Adjusting for demographic factors and neighborhood safety, African Americans had lower perceived fairness compared to whites (adjusted odds ratio, aOR 0.45; 95% confidence intervals, CI 0.26-0.79; p < 0.005). Other factors associated with lower perceived fairness included Asian-language compared to English-language interview (aOR 0.29; 95% CI 0.11-0.76; p < 0.05) and lower compared to higher neighborhood safety (aOR 0.48; 95% CI 0.31-0.74; p < 0.005). Among African Americans, participants aged 18-29 years were less likely to report perceived fairness (aOR 0.06; 95% CI 0.01-0.59) compared to participants older than 60 years of age. Among Asian/Pacific Islanders, Asian-language interview (aOR 0.07; 95% CI 0.01-0.48) and lower perceived neighborhood safety (aOR 0.01; 95% CI <0.01-0.13) were associated with perceived fairness.

CONCLUSIONS

To strengthen bioterrorism preparedness, public health officials must continue to improve perceived fairness among African American and Asian/Pacific Islander communities.

摘要

目标

在灾难性生物恐怖主义事件期间，公共卫生部门的有效性将需要不同社区的信任。本研究描述了公众对公共卫生系统在生物恐怖主义事件中会公平回应个人需求的看法差异，无论种族/民族、收入或其他特征如何。

方法

利用洛杉矶县健康调查，这是一项基于人群的随机数字电话调查，我们对种族/民族与感知公平性进行了多变量逻辑回归分析，并对人口统计学因素和感知邻里安全进行了调整。我们按种族/民族亚组进行了类似分析。

结果

总体而言，72.7%的受访者认为公共卫生系统在生物恐怖主义事件中会做出公平回应。非裔美国人（AA）和亚太岛民（API）报告的感知公平性最低（AA为63.0%，API为68.2%，拉丁裔为73.1%，白人为76.6%，组间差异p = 0.005）。在调整了人口统计学因素和邻里安全后，与白人相比，非裔美国人的感知公平性较低（调整后的优势比，aOR为0.45；95%置信区间，CI为0.26 - 0.79；p < 0.005）。与较低感知公平性相关的其他因素包括与英语访谈相比的亚洲语言访谈（aOR为0.29；95% CI为0.11 - 0.76；p < 0.05）以及与较高邻里安全相比的较低邻里安全（aOR为0.48；95% CI为0.31 - 0.74；p < 0.005）。在非裔美国人中，与60岁以上的参与者相比，18 - 29岁的参与者报告感知公平性的可能性较小（aOR为0.06；95% CI为0.01 - 0.59）。在亚太岛民中，亚洲语言访谈（aOR为0.07；95% CI为0.01 - 0.48）和较低的邻里安全感知（aOR为0.01；95% CI <0.01 - 0.13）与感知公平性相关。