Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Am J Public Health. 2011 Mar;101(3):554-60. doi: 10.2105/AJPH.2009.171157. Epub 2011 Jan 13.
We created an index quantifying the longitudinal burden of racial health disparities by state and compared this index to variables to guide the construction of, and validate support for, legislative efforts aimed at eliminating health disparities.
We evaluated 5 focus areas of greatest racial disparities in health from 1999 to 2005 and compiled state health disparities index (HDI) scores. We compared these scores with variables representing the purported social determinants of health.
Massachusetts (0.35), Oklahoma (0.35), and Washington (0.39) averaged the fewest disparities. Michigan (1.22), Wisconsin (1.32), and Illinois (1.50) averaged the greatest disparities. The statistical reference point for nationwide average racial disparities was 1.00. The longitudinal mixed model procedure yielded statistically significant correlations between HDI scores and Black state population percentage as well as with the racial gap in uninsured percentages. We noted a trend for HDI correlations with median household income ratios.
On the basis of the HDI-established trends in the extent and distribution of racial health disparities, and their correlated social determinants of health, policymakers should consider incorporating this tool to advise future efforts in minority health legislation.
我们创建了一个指标，用以量化各州种族健康差异的纵向负担，并将该指标与变量进行比较，旨在为旨在消除健康差异的立法工作提供指导和支持。
我们评估了 1999 年至 2005 年健康方面五个最大的种族差异重点领域，并编制了州健康差异指数（HDI）得分。我们将这些分数与代表健康所谓社会决定因素的变量进行了比较。
马萨诸塞州（0.35）、俄克拉荷马州（0.35）和华盛顿州（0.39）的平均差异最小。密歇根州（1.22）、威斯康星州（1.32）和伊利诺伊州（1.50）的平均差异最大。全国平均种族差异的统计参考点为 1.00。纵向混合模型程序得出了 HDI 分数与黑人州人口百分比以及未参保人口百分比的种族差距之间存在统计学显著相关性的结论。我们注意到 HDI 与家庭收入中位数比率之间存在相关性的趋势。
基于 HDI 确定的种族健康差异的程度和分布趋势及其相关的健康社会决定因素，政策制定者应考虑采用这一工具，为少数民族健康立法的未来努力提供建议。
