Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
J Racial Ethn Health Disparities. 2020 Oct;7(5):838-843. doi: 10.1007/s40615-020-00705-x. Epub 2020 Jan 31.
Racial/ethnic disparities in health behaviors and disease outcomes on the national level have persisted over time despite overall improvements in public health. To better understand the changes over time in racial/ethnic health disparities at the county level, we examined the Allegheny County Health Survey (ACHS) for Pittsburgh, PA and the surrounding area, which was conducted in 2009/2010 and 2015/2016 using random digit dialing of residents aged 18 and older. The prevalence rates and rate ratios at each time period were calculated using survey weights and general linear models. The change in prevalence over time was calculated using race-time interaction terms. The results showed a significant improvement in asthma, stroke, cholesterol, and fair or poor health disparities as well as persistent disparities in diabetes and hypertension after adjustment for socioeconomic factors. The change over time in the prevalence of fair or poor health in black compared to white respondents was significant, with absolute improvement of approximately 5% versus < 1%, respectively (p = 0.01). These findings demonstrate that some disparities improved while others persist, noting the importance of monitoring the changes over time at the local health department level.
尽管整体公共卫生状况有所改善，但在国家层面上，健康行为和疾病结果的种族/民族差异仍然存在。为了更好地了解县级种族/民族健康差异随时间的变化，我们研究了宾夕法尼亚州匹兹堡及其周边地区的阿勒格尼县健康调查（ACHS），该调查于 2009/2010 年和 2015/2016 年使用随机数字拨号对 18 岁及以上的居民进行了调查。使用调查权重和广义线性模型计算了每个时间段的患病率和比率比。使用种族-时间交互项计算了随时间的患病率变化。结果表明，在调整社会经济因素后，哮喘、中风、胆固醇和健康状况不佳或较差的差异以及糖尿病和高血压的持续差异有所改善。在调整社会经济因素后，与白人受访者相比，黑人受访者健康状况不佳或较差的患病率随时间的变化具有统计学意义，绝对改善约 5%，而<1%（p=0.01）。这些发现表明，一些差异有所改善，而另一些则持续存在，这表明在地方卫生部门层面监测随时间的变化非常重要。
