Moonesinghe Ramal, Beckles Gloria L A
Office of Minority Health and Health Equity, Centers for Disease Control and Prevention , Atlanta, GA , United States.
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, GA , United States.
PeerJ. 2015 Nov 24;3:e1438. doi: 10.7717/peerj.1438. eCollection 2015.
Monitoring national trends in disparities in different diseases could provide measures to evaluate the impact of intervention programs designed to reduce health disparities. In the US, most of the reports that track health disparities provided either relative or absolute disparities or both. However, these two measures of disparities are not only different in scale and magnitude but also the temporal changes in the magnitudes of these measures can occur in opposite directions. The trends for absolute disparity and relative disparity could move in opposite directions when the prevalence of disease in the two populations being compared either increase or decline simultaneously. If the absolute disparity increases but relative disparity declines for consecutive time periods, the absolute disparity increases but relative disparity declines for the combined time periods even with a larger increase in absolute disparity during the combined time periods. Based on random increases or decreases in prevalence of disease for two population groups, there is a higher chance the trends of these two measures could move in opposite directions when the prevalence of disease for the more advantaged group is very small relative to the prevalence of disease for the more disadvantaged group. When prevalence of disease increase or decrease simultaneously for two populations, the increase or decrease in absolute disparity has to be sufficiently large enough to warrant a corresponding increase or decrease in relative disparity. When absolute disparity declines but relative disparity increases, there is some progress in reducing disparities, but the reduction in absolute disparity is not large enough to also reduce relative disparity. When evaluating interventions to reduce health disparities using these two measures, it is important to consider both absolute and relative disparities and consider all the scenarios discussed in this paper to assess the progress towards reducing or eliminating health disparities.
监测不同疾病差异的全国趋势可以提供措施，以评估旨在减少健康差异的干预项目的影响。在美国，大多数追踪健康差异的报告提供了相对差异或绝对差异，或两者都有。然而，这两种差异衡量指标不仅在规模和程度上不同，而且这些指标程度的时间变化方向也可能相反。当被比较的两个人群中疾病患病率同时上升或下降时，绝对差异和相对差异的趋势可能会朝着相反的方向发展。如果连续几个时间段绝对差异增加而相对差异下降，那么即使在合并时间段内绝对差异有更大幅度的增加，合并时间段内绝对差异增加而相对差异下降的情况依然存在。基于两个人群组疾病患病率的随机增减情况，当较优势人群的疾病患病率相对于较劣势人群的疾病患病率非常小时，这两种衡量指标的趋势更有可能朝着相反的方向发展。当两个人群的疾病患病率同时上升或下降时，绝对差异的增加或减少必须足够大，才能保证相对差异相应地增加或减少。当绝对差异下降但相对差异增加时，在减少差异方面取得了一些进展，但绝对差异的减少幅度不足以同时降低相对差异。在使用这两种衡量指标评估减少健康差异的干预措施时，重要的是要同时考虑绝对差异和相对差异，并考虑本文讨论的所有情况，以评估在减少或消除健康差异方面取得的进展。
