Department of Epidemiology, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA.
Carolina Population Center, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA.
Epidemiol Infect. 2019 Nov 11;147:e301. doi: 10.1017/S0950268819001894.
The disproportionate burden of prevalent, persistent pathogens among disadvantaged groups may contribute to socioeconomic and racial/ethnic disparities in long-term health. We assessed if the social patterning of pathogen burden changed over 16 years in a U.S.-representative sample. Data came from 17 660 National Health and Nutrition Examination Survey participants. Pathogen burden was quantified by summing the number of positive serologies for cytomegalovirus, herpes simplex virus-1, HSV-2, human papillomavirus and Toxoplasma gondii and dividing by the number of pathogens tested, giving a percent-seropositive for each participant. We examined sex- and age-adjusted mean pathogen burdens from 1999-2014, stratified by race/ethnicity and SES (poverty-to-income ratio (PIR); educational attainment). Those with a PIR < 1.3 had a mean pathogen burden 1.4-1.8 times those with a PIR > 3.5, with no change over time. Educational disparities were even greater and showed some evidence of increasing over time, with the mean pathogen burden among those with less than a high school education approximately twice that of those who completed more than high school. Non-Hispanic Black, Mexican American and other Hispanic participants had a mean pathogen burden 1.3-1.9 times non-Hispanic Whites. We demonstrate that socioeconomic and racial/ethnic disparities in pathogen burden have persisted across 16 years, with little evidence that the gap is closing.
在弱势群体中，流行的、持续存在的病原体负担不成比例，这可能导致长期健康方面存在社会经济和种族/民族差异。我们评估了在美国代表性样本中，病原体负担的社会模式是否在 16 年内发生了变化。数据来自 17660 名国家健康和营养调查参与者。病原体负担通过对巨细胞病毒、单纯疱疹病毒 1、HSV-2、人乳头瘤病毒和弓形体的阳性血清学进行求和，并除以检测的病原体数量，得出每个参与者的血清阳性百分比来量化。我们检查了 1999-2014 年按种族/族裔和 SES（贫困收入比（PIR）；教育程度）分层的男女调整后平均病原体负担。那些 PIR<1.3 的人的平均病原体负担是 PIR>3.5 的人的 1.4-1.8 倍，且随着时间的推移没有变化。教育方面的差距更大，且随着时间的推移，有证据表明差距在扩大，受教育程度低于高中的人的平均病原体负担大约是完成高中以上学业的人的两倍。非西班牙裔黑人、墨西哥裔美国人和其他西班牙裔参与者的平均病原体负担是非西班牙裔白人的 1.3-1.9 倍。我们证明，病原体负担方面的社会经济和种族/民族差异在 16 年内一直存在，几乎没有证据表明差距正在缩小。
