农村地区的种族和民族居住隔离与医疗保健可及性
Racial and ethnic residential segregation and access to health care in rural areas.
作者信息
Caldwell Julia T, Ford Chandra L, Wallace Steven P, Wang May C, Takahashi Lois M
机构信息
Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, United States; Section of Hospital Medicine, The University of Chicago, Chicago, IL, United States.
Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, United States.
出版信息
Health Place. 2017 Jan;43:104-112. doi: 10.1016/j.healthplace.2016.11.015. Epub 2016 Dec 22.
This study examined the relationship between racial/ethnic residential segregation and access to health care in rural areas. Data from the Medical Expenditure Panel Survey were merged with the American Community Survey and the Area Health Resources Files. Segregation was operationalized using the isolation index separately for African Americans and Hispanics. Multi-level logistic regression with random intercepts estimated four outcomes. In rural areas, segregation contributed to worse access to a usual source of health care but higher reports of health care needs being met among African Americans (Adjusted Odds Ratio [AOR]: 1.42, CI: 0.96-2.10) and Hispanics (AOR: 1.25, CI: 1.05-1.49). By broadening the spatial scale of segregation beyond urban areas, findings showed the complex interaction between social and spatial factors in rural areas.
本研究考察了农村地区种族/族裔居住隔离与医疗保健可及性之间的关系。医疗支出面板调查的数据与美国社区调查及地区卫生资源文件进行了合并。分别使用隔离指数对非裔美国人和西班牙裔的隔离情况进行了量化。采用具有随机截距的多层次逻辑回归估计了四个结果。在农村地区，隔离导致获得常规医疗保健来源的机会变差，但非裔美国人（调整优势比[AOR]：1.42，置信区间[CI]：0.96 - 2.10）和西班牙裔（AOR：1.25，CI：1.05 - 1.49）中报告的医疗保健需求得到满足的比例更高。通过将隔离的空间尺度扩展到城市地区以外，研究结果显示了农村地区社会和空间因素之间复杂的相互作用。
Zotero 插件