Department of Health Policy and Management, Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Med Care Res Rev. 2012 Apr;69(2):158-75. doi: 10.1177/1077558711420263. Epub 2011 Oct 4.
Using data from the 2006 Medical Expenditure Panel Survey and the 2000 Census, the authors explored whether race/ethnic disparities in health care use were associated with residential segregation. They used five measures of health care use: office-based physician visits, outpatient department physician visits, visits to nurses and physician's assistants, visits to other health professionals, and having a usual source of care. For each individual, the authors controlled for age, gender, marital status, insurance status, income, educational attainment, employment status, region, and health status. The authors used the racial-ethnic composition of the zip code to control for residential segregation. The findings suggest that disparities in health care utilization are related to both individuals' racial and ethnic identity and the racial and ethnic composition of their communities. Therefore, efforts to improve access to health care services and to eliminate health care disparities for African Americans and Hispanics should not only focus on individual-level factors but also include community-level factors.
利用来自 2006 年医疗支出面板调查和 2000 年人口普查的数据，作者探讨了医疗保健使用方面的种族/民族差异是否与居住隔离有关。他们使用了五种医疗保健使用的衡量标准：门诊医生就诊、门诊医生就诊、护士和医师助理就诊、其他卫生专业人员就诊以及有常规医疗服务来源。对于每个人，作者都控制了年龄、性别、婚姻状况、保险状况、收入、教育程度、就业状况、地区和健康状况。作者使用邮政编码的种族和民族构成来控制居住隔离。研究结果表明，医疗保健利用方面的差异既与个人的种族和民族身份有关，也与他们所在社区的种族和民族构成有关。因此，改善非裔美国人和西班牙裔获得医疗保健服务的机会以及消除医疗保健差异的努力不仅应侧重于个人层面的因素，还应包括社区层面的因素。
