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在 COVID-19 大流行早期,与健康相关的社会经济风险中的种族和民族差异:一项对美国女性的全国性调查。

Racial and Ethnic Disparities in Health-Related Socioeconomic Risks During the Early COVID-19 Pandemic: A National Survey of U.S. Women.

机构信息

Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA.

Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

出版信息

J Womens Health (Larchmt). 2021 Oct;30(10):1375-1385. doi: 10.1089/jwh.2021.0230. Epub 2021 Sep 16.

Abstract

Nearly half of U.S. women experienced new or worsening health-related socioeconomic risks (HRSRs) (food, housing, utilities and transportation difficulties, and interpersonal violence) early in the COVID-19 pandemic. We sought to examine racial/ethnic disparities in pandemic-related changes in HRSRs among women. We conducted a cross-sectional survey (04/2020) of 3200 women. Pre- and early pandemic HRSRs were described by race/ethnicity. Weighted, multivariable logistic regression models generated odds of incident and worsening HRSRs by race/ethnicity. The majority of Black, East or Southeast (E/SE) Asian, and Hispanic women reported ≥1 prepandemic HRSR (51%-56% vs. 38% of White women,  < 0.001). By April 2020, 68% of Black, E/SE Asian, and Hispanic women and 55% of White women had ≥1 HRSR ( < 0.001). For most HRSRs, the odds of an incident or worsening condition were similar across racial/ethnic groups, except Black, E/SE Asian and Hispanic women had 2-3.6 times the odds of incident transportation difficulties compared with White women. E/SE Asian women also had higher odds of worsening transportation difficulties compared with White women (adjusted odds ratios = 2.5, 95% confidence interval 1.1-5.6). In the early pandemic, 1/19 Hispanic, 1/28 E/SE Asian, 1/36 Black and 1/100 White women had all 5 HRSRs (extreme health-related socioeconomic vulnerability). Prepandemic racial/ethnic disparities in HRSRs persisted and prevalence rates increased for all groups early in the pandemic. Disparities in transportation difficulties widened. White women were much less likely than others to experience extreme health-related socioeconomic vulnerability. An equitable COVID-19 response requires attention to persistent and widening racial/ethnic disparities in HRSRs among women.

摘要

近一半的美国女性在 COVID-19 大流行早期经历了新的或恶化的与健康相关的社会经济风险(食品、住房、水电费和交通困难以及人际暴力)。我们试图研究女性在大流行期间与 HRSR 相关的变化中存在的种族/民族差异。我们对 3200 名女性进行了一项横断面调查(2020 年 4 月)。按种族/民族描述大流行前和大流行早期的 HRSR。通过加权多变量逻辑回归模型,根据种族/民族生成新发病例和 HRSR 恶化的几率。大多数黑人、东亚或东南亚(E/SE)亚裔和西班牙裔女性报告了≥1 种大流行前 HRSR(51%-56%比白人女性的 38%,<0.001)。到 2020 年 4 月,68%的黑人、E/SE 亚裔和西班牙裔女性和 55%的白人女性至少有 1 种 HRSR(<0.001)。对于大多数 HRSR,在不同种族/民族群体中,新发或恶化情况的几率相似,除了黑人、E/SE 亚裔和西班牙裔女性新发交通困难的几率是白人女性的 2-3.6 倍。E/SE 亚裔女性发生交通困难恶化的几率也高于白人女性(调整后的优势比=2.5,95%置信区间 1.1-5.6)。在大流行早期,1/19 的西班牙裔、1/28 的东亚裔、1/36 的黑人以及 1/100 的白人女性都有所有 5 种 HRSR(极端健康相关的社会经济脆弱性)。大流行前 HRSR 的种族/民族差异持续存在,所有群体在大流行早期的患病率都有所增加。交通困难的差异也在扩大。白人女性发生极端健康相关的社会经济脆弱性的可能性远低于其他群体。要应对大流行期间女性 HRSR 持续存在和不断扩大的种族/民族差异,就需要采取公平的 COVID-19 应对措施。

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