Institute of Population and Public Health, Canadian Institutes for Health Research, 312-600 Peter Morand Crescent, Ottawa, K1G 5Z3, Canada.
BMC Med Res Methodol. 2011 Jul 12;11:104. doi: 10.1186/1471-2288-11-104.
The term 'inequities' refers to avoidable differences rooted in injustice. This review examined whether or not, and how, quantitative studies identifying inequalities in risk factors and health service utilization for asthma explicitly addressed underlying inequities. Asthma was chosen because recent decades have seen strong increases in asthma prevalence in many international settings, and inequalities in risk factors and related outcomes.
A review was conducted of studies that identified social inequalities in asthma-related outcomes or health service use in adult populations. Data were extracted on use of equity terms (objective evidence), and discussion of equity issues without using the exact terms (subjective evidence).
Of the 219 unique articles retrieved, 21 were eligible for inclusion. None used the terms equity/inequity. While all but one article traced at least partial pathways to inequity, only 52% proposed any intervention and 55% of these interventions focused exclusively on the more proximal, clinical level.
Without more in-depth and systematic examination of inequities underlying asthma prevalence, quantitative studies may fail to provide the evidence required to inform equity-oriented interventions to address underlying circumstances restricting opportunities for health.
“不平等”一词是指源于不公正的可避免差异。本综述考察了定量研究在识别哮喘风险因素和卫生服务利用方面的不平等现象时，是否以及如何明确解决潜在的不平等问题。选择哮喘作为研究对象是因为近几十年来，许多国际环境中的哮喘患病率都大幅上升，同时风险因素和相关结果也存在不平等现象。
对识别成人哮喘相关结局或卫生服务使用方面的社会不平等的研究进行了综述。对使用公平术语（客观证据）和讨论公平问题（主观证据）进行了数据提取，而不使用确切术语。
在检索到的 219 篇独特文章中，有 21 篇符合纳入标准。没有一篇文章使用了公平/不平等的术语。虽然所有文章都至少追溯了部分通向不公平的途径，但只有 52%的文章提出了任何干预措施，而这些干预措施中有 55%仅集中在更接近临床的近端层面。
如果不对哮喘患病率背后的不平等问题进行更深入和系统的检查，定量研究可能无法提供所需的证据，以告知以公平为导向的干预措施，以解决限制健康机会的根本情况。
