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初级保健、卫生服务与拉丁裔死亡率悖论

Primary Care, Health Services, and the Latino Mortality Paradox.

作者信息

Heintzman John, Marino Miguel

机构信息

Department of Family Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, 97239, Portland, OR, USA.

OCHIN, Inc., Portland, OR, USA.

出版信息

J Immigr Minor Health. 2025 Feb;27(1):6-9. doi: 10.1007/s10903-024-01637-y. Epub 2024 Nov 7.

Abstract

In the United States, populations of Latino individuals tend to have better mortality outcomes than socioeconomically similar racial and ethnic comparators; this has been termed the "Latino Paradox". However, advantages from the Latino paradox seem to fade and may be susceptible to other factors (like the COVID-19 pandemic). Quality primary care may improve mortality, but the effect of the intersection of all of these factors in Latino patients is uncertain. There is burgeoning evidence that Latino patients may have more robust utilization of high value primary care services, especially when accessible in a community-oriented fashion. This utilization may become less robust, especially in services that require a more integrated delivery system, as individuals and generations spend more time in the United States. Primary care research may provide additional insights into the underpinnings of the Latino paradox and may complement the public health foundation that has undergirded work on the paradox in the last few decades. Investments in primary care infrastructure and research may be beneficial to the health of Latinos in the United States, and incorporating the needs of this diverse population into primary care system design at scale may pay large dividends for our societal health.

摘要

在美国,拉丁裔人群的死亡率往往比社会经济状况相似的其他种族和族裔群体更好;这一现象被称为“拉丁裔悖论”。然而,拉丁裔悖论带来的优势似乎正在消退,并且可能受到其他因素(如新冠疫情)的影响。高质量的初级保健可能会降低死亡率,但所有这些因素相互作用对拉丁裔患者的影响尚不确定。越来越多的证据表明,拉丁裔患者可能会更积极地利用高价值的初级保健服务,尤其是当这些服务以社区为导向且易于获得时。随着个人和新一代在美国生活的时间增加,这种利用率可能会降低,尤其是在需要更综合服务体系的服务方面。初级保健研究可能会为拉丁裔悖论的根源提供更多见解,并可能补充过去几十年来支撑该悖论研究的公共卫生基础。对初级保健基础设施和研究的投资可能有利于美国拉丁裔人群的健康,大规模地将这一多样化人群的需求纳入初级保健系统设计可能会给我们的社会健康带来巨大回报。

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