Baylor University, Department of Public Health, Waco, TX 76798 (
University of Iowa, Department of Health Management and Policy, Iowa City, Iowa.
Prev Chronic Dis. 2024 Feb 29;21:E14. doi: 10.5888/pcd21.230267.
We examined the geographic distribution and sociodemographic and economic characteristics of chronic disease prevalence in the US. Understanding disease prevalence and its impact on communities is crucial for effective public health interventions.
Data came from the American Community Survey, the American Hospital Association Survey, and the Centers for Disease Control and Prevention's PLACES. We used quartile thresholds for 10 chronic diseases to assess chronic disease prevalence by Zip Code Tabulation Areas (ZCTAs). ZCTAs were scored from 0 to 20 based on their chronic disease prevalence quartile. Three prevalence categories were established: least prevalent (score ≤6), moderately prevalent (score 7-13), and highest prevalence (score ≥14). Community characteristics were compared across categories and spatial analyses to identify clusters of ZCTAs with high disease prevalence.
Our study showed a high prevalence of chronic disease in the southeastern region of the US. Populations in ZCTAs with the highest prevalence showed significantly greater socioeconomic disadvantages (ie, lower household income, lower home value, lower educational attainment, and higher uninsured rates) and barriers to health care access (lower percentage of car ownership and longer travel distances to hospital-based intensive care units, emergency departments, federally qualified health centers, and pharmacies) compared with ZCTAs with the lowest prevalence.
Socioeconomic disparities and health care access should be addressed in communities with high chronic disease prevalence. Carefully directed resource allocation and interventions are necessary to reduce the effects of chronic disease on these communities. Policy makers and clinicians should prioritize efforts to reduce chronic disease prevalence and improve the overall health and well-being of affected communities throughout the US.
我们研究了美国慢性疾病的地理分布以及社会人口和经济特征。了解疾病的流行情况及其对社区的影响对于有效的公共卫生干预至关重要。
数据来自美国社区调查、美国医院协会调查和疾病控制与预防中心的 PLACES。我们使用四分位数阈值来评估邮政编码区(ZCTA)的 10 种慢性疾病的患病率。根据慢性疾病患病率的四分位范围,ZCTA 的评分范围为 0 到 20。根据慢性疾病的患病率,将 ZCTA 分为三个类别:最低患病率(评分≤6)、中等患病率(评分 7-13)和最高患病率(评分≥14)。对各个类别进行社区特征比较,并进行空间分析以识别高疾病流行的 ZCTA 聚类。
我们的研究表明,美国东南部地区慢性疾病的患病率较高。在最高患病率的 ZCTA 中,人口的社会经济劣势明显更大(即家庭收入较低、住房价值较低、教育程度较低和未参保率较高),获得医疗保健的障碍也更多(汽车拥有率较低,前往医院重症监护室、急诊室、联邦合格的健康中心和药店的旅行距离较长),与最低患病率的 ZCTA 相比。
在慢性疾病高流行的社区中,应解决社会经济差异和医疗保健获取问题。需要有针对性地分配资源和采取干预措施,以减轻慢性疾病对这些社区的影响。政策制定者和临床医生应优先努力降低美国各地慢性疾病的流行率,并改善受影响社区的整体健康和福祉。