General and Adolescent Paediatrics Unit, UCL Institute of Child Health, , London, UK.
Arch Dis Child. 2013 Nov;98(11):850-5. doi: 10.1136/archdischild-2012-303403. Epub 2013 May 30.
To investigate trends in health inequality among children and young people between 1999 and 2009, using outcomes consistent with the current NHS reforms.
DESIGN/DATA: Secondary analysis of participants aged 0-24 in the Health Surveys for England (HSE) undertaken in 1999, 2004, 2006 and 2009.
Changes in the absolute and relative risks of four health outcomes by deprivation tertiles, based on occupation of the head of household: self/parent-reported general health; presence of a long-standing illness (LSI); obesity; smoking.
No indicator showed a reduction in relative or absolute inequality between 1999 and 2009. For children (0-12 years), the relative risk comparing the most and least deprived tertiles increased significantly for poor general health (1999:1.6 (95% CI 1.2 to 2.2); 2009:3.9 (2.4 to 6.2), while the absolute difference in LSI prevalence(%) increased from 1.3 (-2.9 to 5.5) to 7.4 (3.6 to 11.4). Among young people (13-24 years), the absolute difference in LSI prevalence increased from -5.9 (-10.9 to -1.1) to 3.1 (-4.1 to 10.7). Absolute inequality in having tried smoking among children aged 8-15(%) increased significantly in the first half of the decade before decreasing in the second half (1999:3.3 (-1.1 to 7.7); 2004:14.1 (9.6 to 18.8); 2009:4.1 (0.1 to 8.8)). However, the increase in absolute inequality for smoking prevalence among young adults (16-24 years) was maintained throughout the decade (1999:-7.0 (-15.6 to 1.3); 2004:11.6 (3.7 to 20.0); 2009:8.2 (-0.3 to 16.9)).
The national programme between 1999 and 2009 was not successful in reducing inequality in four key indicators of health status and future health risk among children and young people. Some inequality measures for general health, LSI prevalence and smoking increased over this time.
利用与当前国民保健制度改革一致的结果，调查 1999 年至 2009 年期间儿童和年轻人健康不平等的趋势。
设计/数据：对英格兰健康调查（HSE）中年龄在 0-24 岁的参与者进行的二次分析，该调查分别于 1999 年、2004 年、2006 年和 2009 年进行。
根据家庭户主的职业，按贫困程度分为三分之一，评估四个健康结果的绝对风险和相对风险的变化：自我/家长报告的一般健康状况；长期疾病（LSI）的存在；肥胖；吸烟。
在 1999 年至 2009 年期间，没有任何指标显示相对或绝对不平等程度有所降低。对于儿童（0-12 岁），比较最贫困和最富裕三分之一的相对风险显著增加，表现在一般健康状况较差（1999 年：1.6（95%置信区间 1.2 至 2.2）；2009 年：3.9（2.4 至 6.2），而 LSI 患病率（%）的绝对差异从-2.9 增加到 5.5）增加到 11.4）。在年轻人（13-24 岁）中，LSI 患病率的绝对差异从-10.9 增加到 1.1）增加到 10.7）。在 8-15 岁儿童尝试吸烟的绝对不平等（%）在十年的前半段显著增加，然后在后半段下降（1999 年：3.3（-1.1 至 7.7）；2004 年：14.1（9.6 至 18.8）；2009 年：4.1（0.1 至 8.8））。然而，青少年（16-24 岁）吸烟率的绝对不平等增加在整个十年中保持不变（1999 年：-7.0（-15.6 至 1.3）；2004 年：11.6（3.7 至 20.0）；2009 年：8.2（-0.3 至 16.9））。
1999 年至 2009 年期间，国家计划未能成功减少儿童和年轻人健康状况和未来健康风险的四个关键指标的不平等。在此期间，一些关于一般健康、LSI 流行率和吸烟的不平等指标有所增加。
