Dai Dajun, Rothenberg Richard, Luo Ruiyan, Weaver Scott R, Stauber Christine E
Department of Geosciences, College of Arts and Sciences, Georgia State University, 24 Peachtree Center Ave NE, Atlanta, GA, 30303, USA.
School of Public Health, Georgia State University, Atlanta, GA, 30302, USA.
J Urban Health. 2017 Jun;94(3):417-428. doi: 10.1007/s11524-017-0151-4.
Progression of geographic disparities in social determinants of health is a global concern. Using an Urban Health Index (UHI) approach, we proposed a framework of examining the change of geographic disparities in social determinants in small areas. Using the City of Atlanta in Georgia (USA) as a case study, we standardized six census-based social determinant indicators in 2000 and in 2010, respectively, and calculated their geometric mean to assign each census tract a UHI value for 2000 and for 2010. We then evaluated the temporal change of the UHIs in relation to the demographic changes using spatial and statistical methods. We found that Atlanta experienced an improvement in social determinant status and a reduction of disparities in the 10 years. The areas that experienced improvement, however, underwent demographic changes as well. This analysis provides support for displacement, rather than improvement, as the underlying factor for apparent change in geographic disparities. Findings suggest the importance of local evaluation for future policies to reduce disparities in cities.
健康社会决定因素方面地理差异的加剧是一个全球关注的问题。我们采用城市健康指数（UHI）方法，提出了一个用于研究小区域社会决定因素地理差异变化的框架。以美国佐治亚州的亚特兰大市为例，我们分别对2000年和2010年基于人口普查的六个社会决定因素指标进行了标准化，并计算它们的几何平均数，为每个普查区赋予2000年和2010年的城市健康指数值。然后，我们使用空间和统计方法评估了城市健康指数随时间的变化以及人口变化情况。我们发现，亚特兰大在这10年里社会决定因素状况有所改善，差异也有所减少。然而，经历改善的地区也发生了人口变化。该分析支持了人口迁移而非改善是地理差异明显变化的潜在因素这一观点。研究结果表明了地方评估对于未来减少城市差异政策的重要性。
