Rhoades Dorothy A, Manson Spero M, Noonan Carolyn, Buchwald Dedra
American Indian and Alaska Native Programs, Seattle, WA 98199, USA.
J Health Care Poor Underserved. 2005 Aug;16(3):464-74. doi: 10.1353/hpu.2005.0059.
The objectives of this study were to ascertain the extent of, and health-related characteristics associated with, travel to reservations in a low-income, urban American Indian and Alaska Native (AI/AN) population. We surveyed more than 500 AI/AN adults at a primary care clinic. Measures included time spent visiting a reservation during the past year, and sociodemographic, cultural, and clinical characteristics. More than half (52%) of the patients had not traveled, 34% had traveled up to 30 days, and 14% had spent more than 30 days traveling to reservations. Multivariate ordinal regression revealed that a strong Native American cultural identification, presence of lung disease, absence of thyroid and mental problems, and greater dissatisfaction with care were independently associated with more travel to reservations (p<or=0.05). This research begins to augment the paucity of information on such travel and its relationship to health status and use of health services among urban AI/ANs.
本研究的目的是确定美国低收入城市地区印第安人和阿拉斯加原住民(AI/AN)前往保留地旅行的程度以及与之相关的健康特征。我们在一家初级保健诊所对500多名AI/AN成年人进行了调查。测量指标包括过去一年中前往保留地的时间,以及社会人口学、文化和临床特征。超过一半(52%)的患者没有旅行过,34%的患者旅行时间长达30天,14%的患者前往保留地的旅行时间超过30天。多变量有序回归显示,强烈的美洲原住民文化认同、肺部疾病的存在、甲状腺和精神问题的不存在,以及对医疗服务的更大不满与前往保留地的更多旅行独立相关(p≤0.05)。这项研究开始填补关于此类旅行及其与城市AI/AN健康状况和医疗服务使用之间关系的信息空白。