加利福尼亚州美洲原住民部落的赌场所有权与与健康相关的社区资源。

Casino Ownership and Health-Related Community Resources Among Native American Tribes in California.

机构信息

University of Washington School of Public Health, Department of Health Services, 330 Raitt Hall, Seattle WA 98195. Email:

University of Washington School of Public Health, Center for Public Health Nutrition, Seattle, Washington.

出版信息

Prev Chronic Dis. 2019 Feb 7;16:E14. doi: 10.5888/pcd16.180252.

DOI:10.5888/pcd16.180252

PMID:30730831

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6395078/

Abstract

INTRODUCTION

Casinos are significantly associated with improved health among some Native Americans living on tribal lands. An increase in health-related community resources related to tribal ownership of casinos may be one mechanism through which the health of Native Americans is improved. However, no studies have quantitatively assessed whether casinos are associated with having more community resources.

METHODS

To investigate the association between casino ownership and health-related community resources among Native Americans, we surveyed 81 of California's 110 federally recognized tribes about casino ownership and health-related community resources during 2015 and 2016. We created a total health-related community resources score (maximum of 50 points) by grouping resources into 5 subdomains (community infrastructure, health care and education, social determinants, recreational infrastructure, and recreation programs), which we scored for a maximum of 10 points each and then summed. Casino ownership was our independent variable. We used adjusted linear regression models to test the association between casino ownership and health-related community resources.

RESULTS

Half (49%) of the tribes surveyed owned a casino. Compared with tribes without casinos, tribes with casinos had higher total health-related community resource scores (β = 5.09; 90% confidence interval [CI], 1.17-9.01). Casino-owning tribes had more resources related to community infrastructure (β = 1.81; 90% CI, 0.81-2.80), social determinants of health (β = 1.45; 90% CI, 0.24-2.67) and recreational infrastructure (β = 1.08; 90% CI, 0.24-1.92) compared with tribes without casinos.

CONCLUSIONS

Casino ownership is significantly associated with health-related community resources. Future research should assess whether community resources mediate the relationship between economic resources and health among Native Americans.

摘要

简介

赌场与一些生活在部落土地上的美洲原住民的健康状况显著改善有关。与部落拥有赌场相关的健康相关社区资源的增加可能是改善美洲原住民健康的一种机制。然而，尚无研究定量评估赌场是否与拥有更多社区资源有关。

方法

为了调查赌场所有权与美洲原住民健康相关社区资源之间的关联，我们在 2015 年至 2016 年期间对加利福尼亚州 110 个联邦认可的部落中的 81 个部落进行了关于赌场所有权和健康相关社区资源的调查。我们通过将资源分为 5 个子域（社区基础设施、医疗保健和教育、社会决定因素、娱乐基础设施和娱乐项目）来创建一个总健康相关社区资源评分（最高 50 分），我们对每个子域的资源评分最高为 10 分，然后求和。赌场所有权是我们的自变量。我们使用调整后的线性回归模型来测试赌场所有权与健康相关社区资源之间的关联。

结果

在所调查的部落中，有一半（49%）拥有一家赌场。与没有赌场的部落相比，拥有赌场的部落的总健康相关社区资源评分更高（β=5.09；90%置信区间[CI]，1.17-9.01）。与没有赌场的部落相比，拥有赌场的部落拥有更多与社区基础设施（β=1.81；90%CI，0.81-2.80）、健康的社会决定因素（β=1.45；90%CI，0.24-2.67）和娱乐基础设施（β=1.08；90%CI，0.24-1.92）相关的资源。