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1999 - 2020年美国与墨西哥边境地区间质性肺疾病死亡率差异

Interstitial Lung Disease Mortality Disparities Along the US-Mexico Border, 1999-2020.

作者信息

Soin Sabrina, Ibrahim Ramzi, Kusupati Vinita, Sainbayar Enkhtsogt, Pham Hoang Nhat, Natt Bhupinder, Ferreira João Paulo, Ussavarungsi Kamonpun, Low See-Wei

机构信息

Department of Medicine, University of Arizona Tucson, Tucson, AZ.

Department of Medicine, University of Arizona Tucson, Tucson, AZ.

出版信息

Chest. 2024 Dec;166(6):1455-1462. doi: 10.1016/j.chest.2024.07.001. Epub 2024 Jul 18.

Abstract

BACKGROUND

Optimal diagnosis and management of interstitial lung diseases (ILDs) needs access to specialized centers, frequent monitoring, and complex therapeutic options. In underprivileged areas, these necessities can often lead to barriers in delivering care.

RESEARCH QUESTION

What are the ILD mortality disparities in the regions along the US-Mexico (US-MX) border?

STUDY DESIGN AND METHODS

We obtained ILD mortality information through death certificate queries from the Centers for Disease Control and Prevention repository. Death data were adjusted for age and stratified by US-MX border regions and nonborder regions in the United States. Log-linear regression models were used to analyze mortality trends in the period from 1999 to 2020 followed by calculation of annual percentage changes (APCs). Age-adjusted mortality rates (AAMRs) were compared across cumulative and subdemographic populations.

RESULTS

ILD-related mortality among border regions (AAMR, 5.31) was higher than nonborder regions (AAMR, 4.86). Mortality within border regions remained unchanged from 1999 to 2020 (APC, 0.3; P = .269). Nonborder regions experienced a significant rise in mortality rates (APC, 2.6; P = .017) from 1999 to 2005 and remained unchanged from 2005 to 2020. Mortality was higher within both men (AAMR, 6.57) and women (AAMR, 4.36) populations among border regions compared with their nonborder counterparts (AAMR, 6.27 and 3.87, respectively). Hispanic populations among the border regions experienced higher mortality rates (AAMR, 6.15) than Hispanic populations within nonborder regions (AAMR, 5.44). Non-Hispanic populations encountered similar mortality rates between the two regions. Mortality rates among Hispanic (APC, 0.0; P = .938) and non-Hispanic (APC, 0.2; P = .531) populations in the border regions remained unchanged from 1999 to 2020.

INTERPRETATION

These results revealed ILD-related mortality disparities among the US-MX border regions, emphasizing the importance of public health measures to increase access to equitable medical care and implement targeted interventions among these vulnerable populations.

摘要

背景

间质性肺疾病(ILDs)的最佳诊断和管理需要借助专业中心、频繁监测以及复杂的治疗方案。在贫困地区,这些需求往往会导致医疗服务提供方面的障碍。

研究问题

美国 - 墨西哥(美墨)边境沿线地区的ILD死亡率差异是怎样的?

研究设计与方法

我们通过查询疾病控制与预防中心数据库中的死亡证明来获取ILD死亡率信息。对死亡数据进行年龄调整,并按美墨边境地区和美国非边境地区进行分层。使用对数线性回归模型分析1999年至2020年期间的死亡率趋势,随后计算年度百分比变化(APC)。对累积人群和亚人群的年龄调整死亡率(AAMR)进行比较。

结果

边境地区的ILD相关死亡率(AAMR,5.31)高于非边境地区(AAMR,4.86)。1999年至2020年期间,边境地区的死亡率保持不变(APC,0.3;P = 0.269)。非边境地区的死亡率在1999年至2005年期间显著上升(APC,2.6;P = 0.017),并在2005年至2020年期间保持不变。与非边境地区的男性(AAMR,6.27)和女性(AAMR,3.87)相比,边境地区的男性(AAMR,6.57)和女性(AAMR,4.36)死亡率更高。边境地区的西班牙裔人群死亡率(AAMR,6.15)高于非边境地区的西班牙裔人群(AAMR,5.44)。非西班牙裔人群在两个地区的死亡率相似。1999年至2020年期间,边境地区的西班牙裔(APC,0.0;P = 0.938)和非西班牙裔(APC,0.2;P = 0.531)人群死亡率保持不变。

解读

这些结果揭示了美墨边境地区之间与ILD相关的死亡率差异,强调了公共卫生措施对于增加公平医疗服务可及性以及对这些弱势群体实施针对性干预的重要性。

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