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影响美国西班牙裔/拉丁裔儿童神经发育障碍低患病率的因素。

Factors Influencing Low Prevalence of Neurodevelopmental Disabilities Among US Hispanic/Latino Children.

机构信息

Department of Sociology, University of Minnesota, 909 Social Sciences, 267 19th Ave S, Minneapolis, MN, 55455, USA.

Institute on Community Integration, University of Minnesota, 105 Pattee Hall, 150 Pillsbury Dr. SE, Minneapolis, MN, 55455, USA.

出版信息

J Racial Ethn Health Disparities. 2019 Dec;6(6):1107-1121. doi: 10.1007/s40615-019-00613-9. Epub 2019 Jul 10.

Abstract

OBJECTIVES

Hispanic/Latino (H/L) children have lower prevalence of neurodevelopmental disabilities (NDD) than other groups. The explanations for this are complex, but may be related to nativity, language barriers, and lack of access to and utilization of healthcare. Previous research focused on how these factors affect children with NDD, but little research has jointly examined whether these factors predict NDD. This study examines whether social and environmental factors explain low prevalence of NDD in this population.

METHODS

This study uses nationally representative Integrated Public Use Microdata Series National Health Interview Survey data (N = 200,622) and multivariate logistic regression analysis to compare NDD prevalence in white and H/L children (average age of 10.2), and examines whether nativity, healthcare access, healthcare utilization, and language barriers explain this disability disparity.

RESULTS

Findings reveal that the H/L NDD disparity is not explained by differences in access to or utilization of healthcare, or as a result of language differences that may create barriers to NDD diagnosis. While H/L children whose sampled adult was born in the USA have lower rates of NDD than whites, H/Ls whose sampled adult were not born in the USA have even lower probability of NDD than H/Ls who were born in the USA.

CONCLUSIONS

These findings may be a result of cultural differences in knowledge or understanding of what constitutes a disability or the result of differential treatment within the healthcare system among H/Ls. The findings underscore the importance of accessible and culturally appropriate health and clinical care interventions among H/L communities.

摘要

目的

西班牙裔/拉丁裔(H/L)儿童的神经发育障碍(NDD)患病率低于其他群体。造成这种情况的原因很复杂,但可能与出生地、语言障碍以及缺乏和无法利用医疗保健有关。先前的研究集中在这些因素如何影响患有 NDD 的儿童,但很少有研究共同探讨这些因素是否预测 NDD。本研究考察了社会和环境因素是否可以解释该人群中 NDD 患病率较低的原因。

方法

本研究使用具有全国代表性的综合公共使用微观数据系列国家健康访谈调查数据(N=200622)和多变量逻辑回归分析来比较白人和 H/L 儿童(平均年龄为 10.2 岁)的 NDD 患病率,并考察了出生地、医疗保健的可及性、医疗保健的利用率和语言障碍是否可以解释这种残疾差异。

结果

研究结果表明,H/L 的 NDD 差异不能用医疗保健的可及性或利用率的差异来解释,也不能用可能导致 NDD 诊断障碍的语言差异来解释。虽然在美国出生的抽样成年人的 H/L 儿童的 NDD 发生率较低,但在非美国出生的 H/L 儿童的 NDD 发生率甚至低于在美国出生的 H/L 儿童。

结论

这些发现可能是由于对残疾构成的知识或理解方面的文化差异,或者是 H/L 群体在医疗保健系统中受到不同待遇的结果。这些发现强调了在 H/L 社区中提供可及和文化适宜的健康和临床护理干预措施的重要性。

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