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代谢综合征与空间差异:社会经济剥夺和医疗资源可及性在台湾旗津区的作用

Metabolic syndrome and spatial disparities: The role of socioeconomic deprivation and medical resource availability in the Cijin district, Taiwan.

作者信息

Su Pei-Hung, Tsai Jong-Rung, Chang Wei-Lun, Hsieh Hui-Min

机构信息

Kaohsiung Municipal Ci-Jin Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University.

Department of Business Management, Ph.D. Program of Health Care Management, National Sun Yat-sen University, Kaohsiung, Taiwan.

出版信息

Kaohsiung J Med Sci. 2024 Dec;40(12):1106-1117. doi: 10.1002/kjm2.12908. Epub 2024 Nov 14.

Abstract

Metabolic syndrome (MetS) is a global health concern with spatial disparities, especially in disadvantaged neighborhoods. This study aimed to examine the association between area-level socioeconomic deprivation, the availability of medical resources in disadvantaged areas such as the Cijin district, and the prevalence of MetS in Taiwan. We used two representative secondary cross-sectional datasets, including physical examinations and lifestyle surveys from 2016 to 2020, sourced from the Taiwan Biobank and the Cijin District Adult Lifestyle and Health Survey. Our findings indicate that residing in the Cijin district, characterized by socioeconomic deprivation and limited medical resources, is associated with significantly higher odds of MetS (aOR = 1.45, 95% CI = 1.28-1.64, p <0.001). Additionally, living in areas with medium (aOR = 1.12, 95% CI = 1.07-1.17, p <0.001) and high area-level socioeconomic deprivation indexes (aOR = 1.13, 95% CI = 1.01-1.25, p <0.001) is linked to a higher likelihood of MetS. Conversely, residing in high medical resource availability index areas is associated with a lower risk of MetS (aOR = 0.92, 95% CI = 0.86-0.99, p = 0.026). We found a link between socioeconomic deprivation and limited medical resources, especially in disadvantaged areas such as the Cijin district, contributing to a higher MetS risk. Residents in these areas often struggle to access healthcare and preventive care. Addressing these disparities requires comprehensive public health initiatives and targeted policy interventions to improve residents' well-being.

摘要

代谢综合征(MetS)是一个存在空间差异的全球性健康问题,在弱势社区尤为突出。本研究旨在探讨地区层面的社会经济剥夺、旗津区等弱势地区医疗资源的可及性与台湾地区代谢综合征患病率之间的关联。我们使用了两个具有代表性的二次横断面数据集,包括2016年至2020年的体格检查和生活方式调查,数据分别来自台湾生物银行和旗津区成人生活方式与健康调查。我们的研究结果表明,居住在以社会经济剥夺和医疗资源有限为特征的旗津区,患代谢综合征的几率显著更高(调整后比值比[aOR]=1.45,95%置信区间[CI]=1.28-1.64,p<0.001)。此外,生活在地区层面社会经济剥夺指数中等(aOR=1.12,95%CI=1.07-1.17,p<0.001)和高(aOR=1.13,95%CI=1.01-1.25,p<0.001)的地区与患代谢综合征的可能性更高有关。相反,居住在医疗资源可及性指数高的地区与患代谢综合征的风险较低有关(aOR=0.92,95%CI=0.86-0.99,p=0.026)。我们发现社会经济剥夺与医疗资源有限之间存在关联,尤其是在旗津区等弱势地区,这导致了更高的代谢综合征风险。这些地区的居民往往难以获得医疗保健和预防保健服务。解决这些差异需要全面的公共卫生举措和有针对性的政策干预措施,以改善居民的健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dec1/11895081/a421f9114cc4/KJM2-40-1106-g002.jpg

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