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医疗保健在高档化社区的使用中的种族差异。

Racial Disparities in Health Care Use in Gentrifying Neighborhoods.

机构信息

Johns Hopkins University, Baltimore, MD.

Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

出版信息

Ethn Dis. 2024 May 27;34(1):25-32. doi: 10.18865/ed.34.1.25. eCollection 2024 Jan.

Abstract

OBJECTIVE

Racial disparities in health outcomes are a persistent threat in gentrifying neighborhoods. A contributor to health outcomes is health services utilization, the extent to which people receive care from a medical professional. There are documented racial disparities in health services utilization in the general population. We aim to determine whether racial disparities in health services utilization exist in gentrifying neighborhoods.

METHODS

We used data from the American Community Survey to identify gentrifying neighborhoods across the United States from 2006 to 2017. We collected data on three measures of healthcare services utilization (office-based physician visits, office-based nonphysician visits, and having a usual source of care) for 247 Black and 689 White non-Hispanic respondents of the 2014 Medical Expenditure Panel Survey living in gentrifying neighborhoods. We used modified Poisson models to determine whether there is a difference in the prevalence of health services utilization by race among residents of gentrifying neighborhoods.

RESULTS

After adjusting for age, gender, education, income, employment, insurance, marital status, region, and self-rated health, Black residents of gentrifying neighborhoods demonstrated a similar prevalence of having an office-based physician visit, a lower prevalence of having an office-based nonphysician visit (prevalence ratio: 0.74; 95% confidence interval, 0.60 to 0.91), and a lower prevalence of having a usual source of care (prevalence ratio: 0.87; 95% confidence interval, 0.77 to 0.98) than White residents.

CONCLUSIONS

The existence of racial disparities in health services utilization in US gentrifying neighborhoods demonstrates a need for policy-relevant solutions to create a more equitable distribution of health resources.

摘要

目的

在不断发展的社区中,健康结果的种族差异是一个持续存在的威胁。健康结果的一个促成因素是卫生服务的利用,即人们从医疗专业人员那里获得护理的程度。在一般人群中,卫生服务利用存在有据可查的种族差异。我们旨在确定在不断发展的社区中是否存在卫生服务利用的种族差异。

方法

我们使用美国社区调查的数据,从 2006 年到 2017 年确定了美国各地不断发展的社区。我们为居住在不断发展的社区的 247 名非裔美国人和 689 名非西班牙裔白人收集了三种医疗服务利用措施的数据(门诊医生就诊、门诊非医生就诊和有常规医疗来源)。我们使用修正泊松模型来确定在不断发展的社区居民中,种族之间卫生服务利用的流行率是否存在差异。

结果

在调整了年龄、性别、教育、收入、就业、保险、婚姻状况、地区和自我评估健康状况后,不断发展的社区中的非裔美国居民表现出类似的门诊医生就诊流行率,门诊非医生就诊的流行率较低(流行率比:0.74;95%置信区间,0.60 至 0.91),并且常规医疗来源的流行率较低(流行率比:0.87;95%置信区间,0.77 至 0.98),而非西班牙裔白人居民。

结论

在美国不断发展的社区中,卫生服务利用的种族差异的存在表明需要有针对性的政策解决方案来创造更公平的卫生资源分配。

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