Ramraj Chantel, Shahidi Faraz Vahid, Darity William, Kawachi Ichiro, Zuberi Daniyal, Siddiqi Arjumand
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Soc Sci Med. 2016 Jul;161:19-26. doi: 10.1016/j.socscimed.2016.05.028. Epub 2016 May 18.
Prior research suggests that racial inequalities in health vary in magnitude across societies. This paper uses the largest nationally representative samples available to compare racial inequalities in health in the United States and Canada. Data were obtained from ten waves of the National Health Interview Survey (n = 162,271,885) and the Canadian Community Health Survey (n = 19,906,131) from 2000 to 2010. We estimated crude and adjusted odds ratios, and risk differences across racial groups for a range of health outcomes in each country. Patterns of racial health inequalities differed across the United States and Canada. After adjusting for covariates, black-white and Hispanic-white inequalities were relatively larger in the United States, while aboriginal-white inequalities were larger in Canada. In both countries, socioeconomic factors did not explain inequalities across racial groups to the same extent. In conclusion, while racial inequalities in health exist in both the United States and Canada, the magnitudes of these inequalities as well as the racial groups affected by them, differ considerably across the two countries. This suggests that the relationship between race and health varies as a function of the societal context in which it operates.
先前的研究表明，不同社会中健康方面的种族不平等程度各异。本文利用现有的最大规模全国代表性样本，比较美国和加拿大健康方面的种族不平等情况。数据取自2000年至2010年期间的十轮美国国家健康访谈调查（n = 162,271,885）和加拿大社区健康调查（n = 19,906,131）。我们估算了每个国家不同种族群体在一系列健康结果方面的粗比值比和调整后比值比以及风险差异。美国和加拿大的种族健康不平等模式有所不同。在对协变量进行调整后，美国黑人和白人以及西班牙裔和白人之间的不平等相对更大，而加拿大原住民和白人之间的不平等更大。在这两个国家，社会经济因素对不同种族群体间不平等的解释程度并不相同。总之，虽然美国和加拿大都存在健康方面的种族不平等，但这些不平等的程度以及受其影响的种族群体在两国之间存在很大差异。这表明种族与健康之间的关系会因所处的社会背景而有所不同。
