美国慢性病成人的健康相关社会需求和健康的社会决定因素,2022 年行为风险因素监测系统。

Social Determinants of Health and Health-Related Social Needs Among Adults With Chronic Diseases in the United States, Behavioral Risk Factor Surveillance System, 2022.

机构信息

National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Prevention and Control, 4770 Buford Hwy NE, Atlanta, GA 30341 (

National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

Prev Chronic Dis. 2024 Nov 27;21:E94. doi: 10.5888/pcd21.240362.

Abstract

INTRODUCTION

The relationship between social determinants of health (SDOH) and health-related social needs (HRSN) and some chronic diseases at the population level is not well known. We sought to determine relationships between SDOH/HRSN and major chronic diseases among US adults by using data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS).

METHODS

We used data from the new Social Determinants and Health Equity (SD/HE) module, conducted in 39 states, the District of Columbia, and 2 territories as part of the 2022 BRFSS. These data yielded a sample of 324,631 adult participants (aged ≥18 y). We examined 12 indicators of SDOH/HRSN and 9 chronic diseases. We calculated weighted prevalence estimates for each SDOH/HRSN measure for each chronic disease and associations between each SDOH/HRSN and each chronic disease.

RESULTS

Two-thirds of participants (66.3%) had 1 or more chronic diseases, and 59.4% reported 1 or more adverse SDOH/HRSN. Prevalence estimates for individual SDOH/HRSN measures were generally higher among participants with chronic diseases (except cancer). The more chronic diseases reported, the more likely participants were to have SDOH/HRSN (P < .05 for linear trend). The leading SDOH/HRSN measures associated with each chronic disease varied; however, the most common were mental stress, receiving food stamps or participating in the Supplemental Nutrition Assistance Program, cost as a barrier for needed medical care, and life dissatisfaction.

CONCLUSION

From a treatment and prevention perspective, health care providers should consider the influence of SDOH/HRSN on people with or at risk for chronic diseases. Additionally, human service and public health systems in communities with high rates of chronic disease should consider these findings as they plan to mitigate adverse SDOH.

摘要

简介

社会决定因素(SDOH)和健康相关社会需求(HRSN)与人群中某些慢性病之间的关系尚不清楚。我们试图通过使用来自 2022 年行为风险因素监测系统(BRFSS)的数据,确定美国成年人中 SDOH/HRSN 与主要慢性病之间的关系。

方法

我们使用了来自新的社会决定因素和健康公平(SD/HE)模块的数据,该模块在 39 个州、哥伦比亚特区和 2 个地区进行,作为 2022 年 BRFSS 的一部分。这些数据产生了 324631 名成年参与者(年龄≥18 岁)的样本。我们检查了 12 项 SDOH/HRSN 指标和 9 种慢性病。我们为每种慢性病计算了每个 SDOH/HRSN 指标的加权患病率估计值,以及每个 SDOH/HRSN 与每种慢性病之间的关联。

结果

三分之二的参与者(66.3%)患有 1 种或多种慢性病,59.4%的参与者报告了 1 种或多种不利的 SDOH/HRSN。慢性病患者的个别 SDOH/HRSN 指标的患病率估计值通常较高(癌症除外)。报告的慢性病越多,参与者患有 SDOH/HRSN 的可能性就越大(线性趋势的 P<0.05)。与每种慢性病相关的主要 SDOH/HRSN 指标各不相同;然而,最常见的是精神压力、领取食品券或参加补充营养援助计划、因费用而无法获得所需医疗保健,以及生活不满。

结论

从治疗和预防的角度来看,医疗保健提供者应该考虑 SDOH/HRSN 对患有慢性病或有患慢性病风险的人的影响。此外,慢性病发病率较高的社区的社会服务和公共卫生系统应在计划减轻不利的 SDOH 时考虑到这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b9a/11608007/660281730980/PCD-21-E94s01.jpg

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