Interator Hagar, Brener Avivit, Hoshen Moshe, Safra Inbar, Balicer Ran, Leshno Moshe, Shamir Raanan, Lebenthal Yael
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Endocrine and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Isr Med Assoc J. 2019 Jun;21(6):369-375.
In Israel, coronary heart disease mortality rates are significantly higher among the Arab population than the Jewish population. Dyslipidemia prevention should begin in childhood.
To identify sociodemographic disparities in the preventive health measurement of lipid profile testing and lipoprotein levels among Israeli children and adolescents.
A cross-sectional analysis of 1.2 million children and adolescents insured by Clalit Health Services between 2007 and 2011 was conducted using sociodemographic data and serum lipid concentrations.
Overall, 10.1% individuals had undergone lipid testing. Those with male sex (odds ratio [OR] = 0.813, 95% confidence interval [95%CI] 0.809-0.816), Arab ethnicity (OR = 0.952, 95%CI 0.941-0.963), and low socioeconomic status (SES) (OR = 0.740, 95%CI 0.728-0.752) were less likely to be tested. By 2010, differences among economic sectors narrowed and Arab children were more likely to be tested (OR = 1.039, 95%CI 1.035-1.044). Girls had higher total cholesterol, triglyceride, low-density lipoprotein-cholesterol, and non-high-density lipoprotein-cholesterol levels compared to boys (P < 0.001). Jewish children had higher cholesterol and low-density and high-density lipoprotein-cholesterol, as well as lower triglyceride levels than Arabs (P < 0.001). Children with low SES had lower cholesterol, low-density and high-density lipoprotein-cholesterol, and non-high-density lipoprotein-cholesterol levels (P < 0.001).
We found that boys, Arab children, and those with low SES were less likely to be tested. Over time there was a gradual reduction in these disparities. Publicly sponsored healthcare services can diminish disparities in the provision of preventive health among diverse socioeconomic groups that comprise the national population.
在以色列，阿拉伯人群的冠心病死亡率显著高于犹太人群。血脂异常的预防应从儿童期开始。
确定以色列儿童和青少年在血脂谱检测和脂蛋白水平预防性健康测量方面的社会人口学差异。
利用社会人口学数据和血清脂质浓度，对2007年至2011年期间由克拉利特医疗服务公司承保的120万儿童和青少年进行横断面分析。
总体而言，10.1%的人进行了血脂检测。男性（优势比[OR]=0.813，95%置信区间[95%CI]0.809 - 0.816）、阿拉伯族裔（OR = 0.952，95%CI 0.941 - 0.963）和社会经济地位（SES）较低（OR = 0.740，95%CI 0.728 - 0.752）的人接受检测的可能性较小。到2010年，经济部门之间的差异缩小，阿拉伯儿童接受检测的可能性更大（OR = 1.039，95%CI 1.035 - 1.044）。与男孩相比，女孩的总胆固醇、甘油三酯、低密度脂蛋白胆固醇和非高密度脂蛋白胆固醇水平更高（P < 0.001）。犹太儿童的胆固醇、低密度和高密度脂蛋白胆固醇水平高于阿拉伯儿童，甘油三酯水平低于阿拉伯儿童（P < 0.001）。SES较低的儿童的胆固醇、低密度和高密度脂蛋白胆固醇以及非高密度脂蛋白胆固醇水平较低（P < 0.001）。
我们发现男孩、阿拉伯儿童和SES较低的人接受检测的可能性较小。随着时间的推移，这些差异逐渐缩小。公共资助的医疗服务可以减少构成国家人口的不同社会经济群体在预防性健康提供方面的差异。
