低收入城市居民针对解决健康问题的社会经济决定因素的干预措施的优先事项。
Priorities of low-income urban residents for interventions to address the socio-economic determinants of health.
作者信息
Danis Marion, Kotwani Namrata, Garrett Joanne, Rivera Ivonne, Davies-Cole John, Carter-Nolan Pamela
机构信息
Bioethics Consultation Service, Dept. of Bioethics; Clinical Center, National Institutes of Health, Bldg. 10, Rm. 1C118, Bethesda, MD 20892-1156, USA.
出版信息
J Health Care Poor Underserved. 2010 Nov;21(4):1318-39. doi: 10.1353/hpu.2010.0929.
OBJECTIVES
To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health.
METHODS
We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions.
RESULTS
Given a budget valued at approximately twice an estimated cost of medical and dental care ($885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions.
CONCLUSIONS
Poor and low-income residents' priorities may usefully inform allocation of social services that affect health.
目标
确定城市低收入居民对于解决健康问题的社会经济决定因素的干预措施的优先次序。
方法
我们挑选并估算了16项与教育、住房、营养、就业、医疗保健、健康行为、社区改善及交通相关的干预措施的成本。华盛顿特区的低收入居民（N = 431）参与了决策活动，以确定这些干预措施的优先次序。
结果
在一项价值约为医疗和牙科保健估计成本两倍（885美元）的预算下，最终被最大比例的个人列为优先事项的干预措施为：医疗保险（95%）、住房券（82%）、牙科保健（82%）、职业培训（72%）、成人教育（63%）、咨询（68%）、健康行为激励措施（68%）及就业安置（67%）。在住房、成人教育以及职业培训和安置方面获得支持的受访者比例远低于将这些干预措施列为优先事项的受访者比例。
结论
贫困和低收入居民的优先事项可能有助于为影响健康的社会服务分配提供参考。
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