College of Health and Human Services, Department of Public Health Sciences, University of North Carolina-Charlotte, 9201 University City Boulevard, Charlotte, NC 28223-0001, USA.
Am J Prev Med. 2010 Mar;38(3):311-6. doi: 10.1016/j.amepre.2009.11.006.
Communities with locally generated special healthcare taxes have demonstrated a generally favorable association with selected population health status outcomes.
This research attempted to determine if that positive association with health outcomes is race differentiated.
Florida counties with multiple special taxing districts were grouped and compared against counties that had either no special healthcare taxing authority or had such authority but were inactive (did not tax). Outcomes of interest were five combined groups and eight cause-specific mortality indicators and five categories of hospitalizations from the 6-year period 2000-2005 analyzed in 2007. Standard mortality ratios and standard hospitalization ratios were calculated separately for white and black populations in four age bands.
Compared to blacks and whites living in communities without special taxing districts, black residents of communities with such districts had larger reductions in mortality for chronic conditions such as cancers, diabetes, stroke, and pneumonia/influenza. The same holds true for hospitalizations for diabetes, congestive heart failure, hypertension, and asthma. These differences were not found in mortality due to HIV, homicide, or motor vehicle crashes. Some differences by taxing district were also age and race differentiated.
In communities with health-related taxing authorities, reductions in health disparities between whites and blacks can be demonstrated. These differences are not uniform and vary by the specific type of outcome, race, and age. These findings support the need for studies that prospectively determine whether implementing new taxing strategies may help reduce health disparities.
拥有本地特殊医疗保健税的社区与特定人群健康状况结果之间普遍存在有利的关联。
本研究试图确定这种与健康结果的积极关联是否存在种族差异。
将拥有多个特殊征税区的佛罗里达州各县分组，并与没有特殊医疗保健征税权或拥有该权力但未征税的县进行比较。在 2007 年分析了 2000 年至 2005 年 6 年期间的五个综合组和八个特定原因死亡率指标以及五类住院治疗数据。针对四个年龄段的白人和黑人，分别计算了标准死亡率比和标准住院率比。
与没有特殊征税区的社区中的黑人和白人相比，生活在有此类征税区的社区中的黑人居民，其慢性疾病（如癌症、糖尿病、中风和肺炎/流感）的死亡率下降幅度更大。对于糖尿病、充血性心力衰竭、高血压和哮喘的住院治疗也是如此。这在因 HIV、凶杀或机动车事故导致的死亡率中并未发现。在死亡率方面，因征税区不同而产生的差异也存在种族和年龄差异。
在有与健康相关的征税机构的社区中，可以证明白人和黑人之间的健康差距有所缩小。这些差异并不统一，具体取决于特定的结果、种族和年龄。这些发现支持了前瞻性研究的必要性，以确定实施新的征税策略是否有助于减少健康差距。
