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2011 - 2014年美国国家健康与营养检查调查中,经社会人口统计学和多种疾病因素调整后美国成年人自我报告健康状况的种族 - 民族差异

Racial-ethnic disparities in self-reported health status among US adults adjusted for sociodemographics and multimorbidities, National Health and Nutrition Examination Survey 2011-2014.

作者信息

Gandhi Krupa, Lim Eunjung, Davis James, Chen John J

机构信息

Office of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.

出版信息

Ethn Health. 2020 Jan;25(1):65-78. doi: 10.1080/13557858.2017.1395812. Epub 2017 Nov 2.

Abstract

To investigate racial-ethnic disparities in self-reported health status adjusting for sociodemographic factors and multimorbidities. A total of 9499 adult participants aged 20 years and older from the United States (US); reported by the National Health and Nutrition Examination Survey (NHANES), a cross-sectional survey - for years 2011-2014. The main outcome measure was self-reported health status categorized as excellent/very good, good (moderate), and fair/poor. Of the NHANES participants, 40.7% reported excellent/very good health, 37.2% moderate health and 22.1% fair/poor health. There were 42.8% who were non-Hispanic whites, 20.2% were Hispanic, 23.8% were non-Hispanic blacks, and 13.2% were non-Hispanic Asians. Compared to non-Hispanic whites, Hispanics [Odds Ratio (OR) = 2.91, 95% Confidence Interval (CI) = 2.28-3.71] and non-Hispanic blacks [OR = 1.51, 95% CI = 1.26-1.83] were more likely to report fair/poor health, whereas, non-Hispanic Asians [OR = 1.42, 95% CI = 1.14-1.76] were more likely to report moderate health than excellent/very good health. Compared to those with no chronic conditions, participants with two or three chronic conditions [OR = 9.35, 95% CI = 7.26-12.00] and with four or more chronic conditions [OR = 38.10, 95% CI = 26.50-54.90] were more likely to report fair/poor health than excellent/very good health status. The racial-ethnic differences in self-reported health persisted even after adjusting for sociodemographics and number of multimorbidities. The findings highlight the potential importance of self-reported health status and the need to increase health awareness through health assessment and health-promotional programs among the vulnerable minority US adults.

摘要

为了研究在调整社会人口学因素和多种疾病并存情况后,自我报告的健康状况中的种族差异。共有9499名年龄在20岁及以上的美国成年参与者;数据由国家健康和营养检查调查(NHANES)报告,这是一项针对2011 - 2014年的横断面调查。主要结局指标是自我报告的健康状况,分为优秀/非常好、良好(中等)以及一般/较差。在NHANES参与者中,40.7%报告健康状况优秀/非常好,37.2%报告健康状况中等,22.1%报告健康状况一般/较差。其中,42.8%是非西班牙裔白人,20.2%是西班牙裔,23.8%是非西班牙裔黑人,13.2%是非西班牙裔亚洲人。与非西班牙裔白人相比,西班牙裔[优势比(OR)= 2.91,95%置信区间(CI)= 2.28 - 3.71]和非西班牙裔黑人[OR = 1.51,95% CI = 1.26 - 1.83]更有可能报告健康状况一般/较差,而非西班牙裔亚洲人[OR = 1.42,95% CI = 1.14 - 1.76]报告健康状况中等的可能性高于报告健康状况优秀/非常好的可能性。与没有慢性病的参与者相比,患有两种或三种慢性病的参与者[OR = 9.35,95% CI = 7.26 - 12.00]以及患有四种或更多慢性病的参与者[OR = 38.10,95% CI = 26.50 - 54.90]报告健康状况一般/较差而非优秀/非常好的可能性更高。即使在调整了社会人口学因素和多种疾病并存的数量后,自我报告健康状况中的种族差异依然存在。这些发现凸显了自我报告健康状况的潜在重要性,以及通过健康评估和健康促进项目提高美国弱势少数族裔成年人健康意识的必要性。

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