Ross Joseph S, Bernheim Susannah M, Bradley Elizabeth H, Teng Hsun-Mei, Gallo William T
Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY 10029, USA.
Prev Med. 2007 Mar;44(3):254-9. doi: 10.1016/j.ypmed.2006.11.006. Epub 2006 Dec 29.
Examine the association between poverty and preventive care use among older working adults.
Cross-sectional analysis of the pooled 1996, 1998 and 2000 waves of the Health and Retirement Study, a nationally representative sample of older community-dwelling adults, studying self-reported use of cervical, breast, and prostate cancer screening, as well as serum cholesterol screening and influenza vaccination. Adults with incomes within 200% of the federal poverty level were defined as poor.
Among 10,088 older working adults, overall preventive care use ranged from 38% (influenza vaccination) to 76% (breast cancer screening). In unadjusted analyses, the working poor were significantly less likely to receive preventive care. After adjustment for insurance coverage, education, and other socio-demographic characteristics, the working poor remained significantly less likely to receive breast cancer (RR 0.92, 95% CI, 0.86-0.96), prostate cancer (RR 0.89, 95% CI, 0.81-0.97), and cholesterol screening (RR 0.91, 95% CI, 0.86-0.96) than the working non-poor, but were not significantly less likely to receive cervical cancer screening (RR 0.96, 95% CI, 0.90-1.01) or influenza vaccination (RR 0.92, 95% CI, 0.84-1.01).
The older working poor are at modestly increased risk for not receiving preventive care.
研究老年在职成年人的贫困状况与预防性医疗服务使用之间的关联。
对1996年、1998年和2000年三轮《健康与退休研究》的数据进行横断面分析，该研究是一项具有全国代表性的针对社区居住老年成年人的样本，研究内容包括自我报告的宫颈癌、乳腺癌和前列腺癌筛查，以及血清胆固醇筛查和流感疫苗接种情况。收入在联邦贫困线200%以内的成年人被定义为贫困人口。
在10088名老年在职成年人中，预防性医疗服务的总体使用率从38%（流感疫苗接种）到76%（乳腺癌筛查）不等。在未经调整的分析中，贫困在职成年人接受预防性医疗服务的可能性显著较低。在调整了保险覆盖、教育程度和其他社会人口学特征后，贫困在职成年人接受乳腺癌筛查（风险比0.92，95%置信区间，0.86 - 0.96）、前列腺癌筛查（风险比0.89，95%置信区间，0.81 - 0.97）和胆固醇筛查（风险比0.91，95%置信区间，0.86 - 0.96）的可能性仍显著低于非贫困在职成年人，但接受宫颈癌筛查（风险比0.96，95%置信区间，0.90 - 1.01）或流感疫苗接种（风险比0.92，95%置信区间，0.84 - 1.01）的可能性与非贫困在职成年人相比无显著差异。
老年贫困在职成年人未接受预防性医疗服务的风险略有增加。
