Jackson Bradford E, Oates Gabriela R, Singh Karan P, Shikany James M, Fouad Mona N, Partridge Edward E, Bae Sejong
a School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA.
b Comprehensive Cancer Center, University of Alabama at Birmingham , Birmingham , AL , USA.
Ethn Health. 2017 Apr;22(2):196-208. doi: 10.1080/13557858.2016.1232805. Epub 2016 Sep 29.
This study examined differences in socio-demographic characteristics and health behaviors relevant to chronic medical conditions (CMCs) in the Mid-South region (Alabama, Mississippi, Louisiana, Kentucky, Tennessee, and Arkansas), and identified subpopulations with increased burden of chronic disease.
Data were obtained from the 2013 Behavioral Risk Factor Surveillance System. The top five most prevalent CMCs in the Mid-South were analyzed: asthma, high blood pressure (HBP), obesity, arthritis, and depression. Adjusted odds ratios (AOR) and confidence intervals (CI) of race-gender combinations were estimated using logistic regression. Differences in associations between socio-demographic characteristics and CMCs according to income were also examined.
The weighted prevalence estimates of the top five CMCs ranged from 66% (asthma) to 20% (depression). Higher income and employment were associated with better outcomes in all five CMCs. Higher educational attainment and physical activity were associated with better HBP, obesity, and arthritis status. Black and white females had higher odds of asthma compared to white males (black AOR = 1.7, CI: 1.1-2.6, white AOR = 1.7, CI: 1.3-2.2). Black males had lower odds of arthritis (AOR = 0.8, CI: 0.6-0.9), while white females had higher odds (AOR = 1.3, CI: 1.2-1.4). Similarly, the odds of depression were lower among black males (AOR = 0.5, CI: 0.4-0.6) and higher among white females (AOR = 2.2, CI: 2.0-2.5). Income-related differences by race were observed for HBP and obesity.
Disparities in CMCs are associated with income and disproportionately affect the black population. In the Mid-South, race and gender disparities in the top five chronic conditions are more prominent among higher-income rather than lower-income individuals.
本研究调查了美国中南部地区(阿拉巴马州、密西西比州、路易斯安那州、肯塔基州、田纳西州和阿肯色州)与慢性疾病(CMC)相关的社会人口学特征和健康行为差异,并确定了慢性病负担加重的亚人群。
数据来自2013年行为危险因素监测系统。分析了中南部地区最常见的五种慢性疾病:哮喘、高血压(HBP)、肥胖、关节炎和抑郁症。使用逻辑回归估计种族-性别组合的调整优势比(AOR)和置信区间(CI)。还研究了社会人口学特征与慢性病之间根据收入的关联差异。
五种最常见慢性病的加权患病率估计范围从66%(哮喘)到20%(抑郁症)。较高的收入和就业与所有五种慢性病的较好结果相关。较高的教育程度和体育活动与较好的高血压、肥胖和关节炎状况相关。与白人男性相比,黑人和白人女性患哮喘的几率更高(黑人AOR = 1.7,CI:1.1 - 2.6,白人AOR = 1.7,CI:1.3 - 2.2)。黑人男性患关节炎的几率较低(AOR = 0.8,CI:0.6 - 0.9),而白人女性的几率较高(AOR = 1.3,CI:1.2 - 1.4)。同样,黑人男性患抑郁症的几率较低(AOR = 0.5,CI:0.4 - 0.6),白人女性的几率较高(AOR = 2.2,CI:2.0 - 2.5)。在高血压和肥胖方面观察到按种族划分的与收入相关的差异。
慢性病的差异与收入相关,并且对黑人人口的影响尤为严重。在美国中南部,前五种慢性病的种族和性别差异在高收入人群中比在低收入人群中更为突出。