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无家可归男性中心血管代谢疾病患病率的种族差异

Racial Differences in Prevalence of Cardiometabolic Morbidities Among Homeless Men.

作者信息

Gao Jie, Gilford Tosi Monifa, Yuen Hon K, Jeon Myung Hwan, Carraway Courtney, Park Gyusik, Diel Stephanie, Patel Alex, Wang Ge, Miller Brianna, Li Wei

机构信息

Clinical Laboratory Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA.

Physician Assistant Studies, School of Health Professions, University of Alabama at Birmingham, 1720 2nd AVE S, Birmingham, AL, 35294, USA.

出版信息

J Racial Ethn Health Disparities. 2022 Apr;9(2):456-461. doi: 10.1007/s40615-021-00976-y. Epub 2021 Feb 4.

DOI:10.1007/s40615-021-00976-y
PMID:33543445
Abstract

INTRODUCTION

Homelessness is associated with an increased risk of cardiometabolic morbidities. However, few studies have been performed to evaluate the racial differences on these morbidities commonly seen in the homeless.

METHODS

A retrospective chart review was conducted to examine the racial differences in the prevalence of cardiometabolic morbidities among the homeless men served at a local health care screening clinic. Medical information was extracted and collated into a single Excel spreadsheet. Racial differences in cardiometabolic morbidities were evaluated using multivariable binary or ordinal logistic regression analyses, adjusting for age, body mass index, and smoking status.

RESULTS

Of the 551 homeless men, 377 (68.4%) were Black, and 174 (31.6%) were White. The mean age (47.8±11.9 years) of Black homeless men was significantly older than that (45.4±13.0 years) of White homeless men (p=0.03). Blacks were 2.7 (95% CI = 1.75, 4.16) times more likely to be in the less desirable HbA1c categories than Whites. By contrast, Blacks were less likely to have non-desirable lipid profile than Whites. Blacks were 0.42 (95% CI = 0.29, 0.62) times and 0.51 (95% CI = 0.28, 0.94) times likely to be in the non-desirable high-density lipoprotein (HDL) and low-density lipoprotein (LDL) categories than Whites, respectively.

CONCLUSION

Black homeless men are more likely to have pre-diabetes or diabetes than White counterparts. On the other hand, Black homeless men have better lipid profiles of HDL or LDL than their White counterparts. Our findings reveal the health challenges of the homeless men and can provide guidance on policy changes related to diet and nutrition of meal programs provided by homeless shelters and congregate meal program to address the health disparities by race in this population.

摘要

引言

无家可归与心血管代谢疾病风险增加有关。然而,很少有研究评估无家可归者中常见的这些疾病的种族差异。

方法

进行了一项回顾性病历审查,以检查在当地医疗筛查诊所接受服务的无家可归男性中,心血管代谢疾病患病率的种族差异。提取医疗信息并整理到一个单一的Excel电子表格中。使用多变量二元或有序逻辑回归分析评估心血管代谢疾病的种族差异,并对年龄、体重指数和吸烟状况进行调整。

结果

在551名无家可归男性中,377名(68.4%)为黑人,174名(31.6%)为白人。黑人无家可归男性的平均年龄(47.8±11.9岁)显著高于白人无家可归男性(45.4±13.0岁)(p=0.03)。黑人处于较不理想糖化血红蛋白(HbA1c)类别的可能性是白人的2.7倍(95%置信区间=1.75,4.16)。相比之下,黑人出现不理想血脂状况的可能性低于白人。黑人处于不理想高密度脂蛋白(HDL)和低密度脂蛋白(LDL)类别的可能性分别是白人的0.42倍(95%置信区间=0.29,0.62)和0.51倍(95%置信区间=0.28,0.94)。

结论

黑人无家可归男性比白人更容易患有糖尿病前期或糖尿病。另一方面,黑人无家可归男性的HDL或LDL血脂状况比白人更好。我们的研究结果揭示了无家可归男性的健康挑战,并可为与无家可归者收容所提供的膳食计划以及集体用餐计划的饮食和营养相关的政策变化提供指导,以解决该人群中因种族导致的健康差异。

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