种族分层模型中县级种族隔离的代理指标与正式指标比较：以田纳西州为例，2005 - 2014年
Comparing proxy and formal measures of county-level racial isolation in race-stratified models: A case study in Tennessee, 2005-2014.
作者信息
Oka Masayoshi, Williams Faustine, Whiteside Martin
机构信息
Department of Management, Faculty of Management, Josai University, Sakado, Saitama, Japan.
Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
出版信息
SSM Popul Health. 2022 Jun 14;19:101146. doi: 10.1016/j.ssmph.2022.101146. eCollection 2022 Sep.
The purpose of this study was to understand whether proxy measures of county-level racial isolation (based on racial compositions) would yield similar results as the formal measures of county-level racial isolation (derived from the isolation index of ). White (non-Hispanic White) and Black (non-Hispanic Black or African American) women residing in the State of Tennessee, USA, and diagnosed with a non-invasive or invasive breast cancer were considered as the study population. Individual-level variables were obtained from the Tennessee Cancer Registry data for the period between 2005 and 2014 (46,983 White women and 7,967 Black women), and county-level variables were obtained from the American Community Survey data for the periods of 2005-2009 and 2010-2014 (95 counties). Using breast cancer condition (non-invasive versus invasive) as the binary outcome of interest, a series of multilevel logistic regression analyses was conducted separately by race. After controlling for individual-level socio-demographic characteristics, proxy measure of county-level White isolation and county-level median household income were not associated with breast cancer condition, but formal measure of county-level White isolation was associated with lower odds of having an invasive breast cancer among White women. On the other hand, neither proxy nor formal measure of county-level Black isolation was associated with breast cancer condition, but county-level median household income was associated with lower odds of having an invasive breast cancer among Black women. These results suggest that using a proxy and formal measure of racial isolation may yield different results, and race-stratified analyses would be helpful for understanding a differential effect of racial isolation on Whites and Blacks. While more detailed examinations are needed in future studies, possible explanations on and reasons behind these findings are discussed.
本研究的目的是了解县级种族隔离的替代指标（基于种族构成）是否会产生与县级种族隔离的正式指标（源自……的隔离指数）相似的结果。居住在美国田纳西州且被诊断患有非侵袭性或侵袭性乳腺癌的白人（非西班牙裔白人）和黑人（非西班牙裔黑人或非裔美国人）女性被视为研究人群。个体层面的变量来自田纳西州癌症登记处2005年至2014年期间的数据（46,983名白人女性和7,967名黑人女性），县级变量来自2005 - 2009年和2010 - 2014年期间的美国社区调查数据（95个县）。以乳腺癌状况（非侵袭性与侵袭性）作为感兴趣的二元结局，按种族分别进行了一系列多水平逻辑回归分析。在控制了个体层面的社会人口学特征后，县级白人隔离的替代指标和县级家庭收入中位数与乳腺癌状况无关，但县级白人隔离的正式指标与白人女性患侵袭性乳腺癌的较低几率相关。另一方面，县级黑人隔离的替代指标和正式指标均与乳腺癌状况无关，但县级家庭收入中位数与黑人女性患侵袭性乳腺癌的较低几率相关。这些结果表明，使用种族隔离的替代指标和正式指标可能会产生不同的结果，并且按种族分层分析有助于理解种族隔离对白人和黑人的不同影响。虽然未来研究需要更详细的检验，但对这些发现的可能解释和背后原因进行了讨论。
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