Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Am J Public Health. 2010 Oct;100(10):1904-11. doi: 10.2105/AJPH.2009.181313. Epub 2010 Aug 19.
We examined associations between the socioeconomic characteristics of census tracts and racial/ethnic disparities in the incidence of bacteremic community-acquired pneumonia among US adults.
We analyzed data on 4870 adults aged 18 years or older with community-acquired bacteremic pneumonia identified through active, population-based surveillance in 9 states and geocoded to census tract of residence. We used data from the 2000 US Census to calculate incidence by age, race/ethnicity, and census tract characteristics and Poisson regression to estimate rate ratios (RRs) and 95% confidence intervals (CIs).
During 2003 to 2004, the average annual incidence of bacteremic pneumonia was 24.2 episodes per 100 000 Black adults versus 10.1 per 100 000 White adults (RR = 2.40; 95% CI = 2.24, 2.57). Incidence among Black residents of census tracts with 20% or more of persons in poverty (most impoverished) was 4.4 times the incidence among White residents of census tracts with less than 5% of persons in poverty (least impoverished). Racial disparities in incidence were reduced but remained significant in models that controlled for age, census tract poverty level, and state.
Adults living in impoverished census tracts are at increased risk of bacteremic pneumonia and should be targeted for prevention efforts.
我们考察了美国成年人中社区获得性菌血症性肺炎发病率的种族/民族差异与普查区社会经济特征之间的关联。
我们分析了 9 个州通过主动、基于人群的监测确定的 4870 名年龄在 18 岁或以上的患有社区获得性菌血症性肺炎的成年人的数据,并将这些数据按照居住地的普查区进行了地理编码。我们使用 2000 年美国人口普查的数据来计算按年龄、种族/民族和普查区特征计算的发病率,并使用泊松回归来估计率比(RR)和 95%置信区间(CI)。
在 2003 年至 2004 年期间,黑人成年人中每 100000 人中有 24.2 例菌血症性肺炎的年平均发病率,而白人成年人中这一数字为每 100000 人中有 10.1 例(RR = 2.40;95%CI = 2.24,2.57)。在贫困率达到或超过 20%(最贫困)的普查区中,黑人居民的发病率是贫困率低于 5%(最不贫困)的普查区中白人居民的发病率的 4.4 倍。在控制年龄、普查区贫困水平和州的模型中,发病率的种族差异虽有所减少,但仍有统计学意义。
生活在贫困普查区的成年人患有菌血症性肺炎的风险增加,应作为预防工作的重点目标。