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苏格兰城乡健康不平等状况比较。

A comparison of health inequalities in urban and rural Scotland.

作者信息

Levin Kate A, Leyland Alastair H

机构信息

University of Dundee, Dundee, UK.

出版信息

Soc Sci Med. 2006 Mar;62(6):1457-64. doi: 10.1016/j.socscimed.2005.08.045. Epub 2005 Sep 22.

Abstract

Previous research suggests that there are significant differences in health between urban and rural areas. Health inequalities between the deprived and affluent in Scotland have been rising over time. The aim of this study was to examine health inequalities between deprived and affluent areas of Scotland for differing ruralities and look at how these have changed over time. Postcode sectors in Scotland were ranked by deprivation and the 20% most affluent and 20% most deprived areas were found using the Carstairs indicator and male unemployment. Scotland was then split into 4 rurality types. Ratios of health status between the most deprived and most affluent areas were investigated using all cause mortality for the Scottish population, 1979-2001. These were calculated over time for 1979-1983, 1989-1993, 1998-2001. Multilevel Poisson modelling was carried out for all of Scotland excluding Grampian to assess inequalities in the population. There was an increase in inequalities between 1981 and 2001, which was greatest in remote rural Scotland for both males and females; however, male health inequalities remained higher in urban areas throughout this period. In 2001 female health inequalities were higher in remote rural areas than urban areas. Health inequalities amongst the elderly (age 65+) in 2001 were greater in remote rural Scotland than urban areas for both males and females.

摘要

先前的研究表明,城乡地区的健康状况存在显著差异。随着时间的推移,苏格兰贫困地区和富裕地区之间的健康不平等现象一直在加剧。本研究的目的是考察苏格兰不同农村地区贫困和富裕地区之间的健康不平等情况,并观察这些不平等现象随时间的变化。苏格兰的邮政编码区根据贫困程度进行排名,并使用卡斯泰尔斯指标和男性失业率找出最富裕的20%地区和最贫困的20%地区。然后,苏格兰被划分为4种农村类型。利用1979 - 2001年苏格兰人口的全因死亡率,研究了最贫困地区和最富裕地区之间的健康状况比率。这些比率是在1979 - 1983年、1989 - 1993年、1998 - 2001年期间计算得出的。对除格兰扁地区外的整个苏格兰进行了多层次泊松建模,以评估总体人群中的不平等情况。1981年至2001年间不平等现象有所增加,在苏格兰偏远农村地区,男性和女性的不平等现象增幅最大;然而,在此期间城市地区男性的健康不平等现象仍然更高。2001年,偏远农村地区女性的健康不平等现象高于城市地区。2001年,苏格兰偏远农村地区65岁及以上老年人中,男性和女性的健康不平等现象均高于城市地区。

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