Department of Health Sciences, DePaul University, Chicago, IL, 60614, USA.
Department of Clinical Psychology, DePaul University, Chicago, IL, 60614, USA.
J Racial Ethn Health Disparities. 2022 Aug;9(4):1152-1160. doi: 10.1007/s40615-021-01056-x. Epub 2021 May 18.
Influenza and pneumonia account for substantial morbidity in the United States and show a demonstrated racial inequity. Detailed race-specific analysis at the city level can be used to guide targeted prevention efforts within the most at-risk communities. The purpose of this study is to analyze city-level data of influenza/pneumonia mortality rates and racial disparities across the 30 biggest U.S. cities over time. We assess racial inequities in influenza/pneumonia mortality in the 30 biggest cities and compare city-level trends overtime through age-adjusted overall and race-specific mortality rates calculated from public death records for the years 2008-2017. The national influenza/pneumonia mortality rate significantly decreased as did 45% of the cities included in the study. Nationally, the Black mortality rate was 16% higher than White mortality rate, and a significant disparity was seen within about one-third of the biggest cities. Over half (56%) of the cities showed reductions in both Black and White mortality; however, there was no overall trend in racial equity with some cities reducing the inequities between the Blacks and Whites and others increasing the inequities. Elevated mortality rates in communities of color can be traced to structural racism, social factors, and access to treatment and prevention services. We recommend an approach utilizing community outreach administered through localized public health organizations and supported by data at the city level.
在美国，流感和肺炎导致了大量的发病率，并且表现出明显的种族不平等。在城市层面进行详细的种族特异性分析可以用来指导最需要预防的社区的有针对性的预防措施。本研究的目的是分析美国 30 个最大城市的流感/肺炎死亡率和种族差异随时间的变化情况。我们评估了 30 个最大城市中流感/肺炎死亡率的种族不平等，并通过公共死亡记录计算的年龄调整后总体和特定种族死亡率来比较随时间推移的城市水平趋势，这些死亡率是从 2008-2017 年的数据中得出的。全国流感/肺炎死亡率显著下降，研究中纳入的 45%的城市也出现了这种情况。在全国范围内，黑人的死亡率比白人高 16%，在大约三分之一的大城市中存在显著的差异。超过一半（56%）的城市黑人和白人的死亡率都有所下降；然而，在种族公平方面并没有总体趋势，一些城市减少了黑人和白人之间的不平等，而另一些城市则增加了这种不平等。有色人种社区的高死亡率可以追溯到结构性种族主义、社会因素以及获得治疗和预防服务的机会。我们建议采用一种方法，通过地方公共卫生组织进行社区外展，并通过城市层面的数据提供支持。
