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中年女性的医疗保健问题:按种族、族裔和邻里社会经济地位划分的差异

Health care concerns in women at midlife: differences by race, ethnicity, and neighborhood socioeconomic status.

作者信息

St Sauver Jennifer L, Kapoor Ekta, Bielinski Suzette J, MacLaughlin Kathy L, Faubion Stephanie S, Jiang Ruoxiang, Rocca Walter A

机构信息

From the Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.

Department of Family Medicine, Mayo Clinic, Rochester, MN.

出版信息

Menopause. 2025 Feb 1;32(2):112-120. doi: 10.1097/GME.0000000000002468. Epub 2024 Dec 17.

Abstract

OBJECTIVES

The aims of the study were to identify conditions diagnosed in at least 10% of midlife women living in the US upper midwest and to assess prevalence by age, race, ethnicity, and sociodemographic status.

METHODS

The Rochester Epidemiology Project was used to conduct a cross-sectional prevalence study of 86,946 women between 40 and 59 years residing in a 27-county region of the United States on January 1, 2020. Diagnostic billing codes were extracted and grouped into broader condition categories using the Clinical Classification System Refined. The prevalence of 424 conditions was calculated by age, race, ethnicity, and area deprivation index quartiles. Logistic regression was used to examine associations between participant characteristics and conditions that affected 10% or more of the study population.

RESULTS

Twenty-eight conditions affected ≥10% of women, and eight conditions increased by ≥45% between the ages of 40 and 59 (disorders of lipid metabolism, hypertension, sleep/wake disorders, thyroid disorders, esophageal disorders, osteoarthritis, tendon and synovial disorders, and menopausal disorders; all test for trend P < 0.01). Black women had a significantly higher prevalence of hypertension and esophageal disorders at all ages (adjusted P values <0.05). Women living in more deprived areas had a significantly higher prevalence of hyperlipidemia, hypertension, sleep/wake disorders, and esophageal disorders (adjusted P values <0.05). Women living in less deprived areas had a significantly higher prevalence of thyroid disorders at age 40 to 44 and menopausal disorders at ages 50 to 59 (adjusted P values <0.05).

CONCLUSIONS

These data suggest that additional attention should focus on Black women and women with a lower socioeconomic status to ensure that common midlife conditions are diagnosed and treated.

摘要

目的

本研究的目的是确定在美国中西部上半区至少10%的中年女性中被诊断出的疾病,并按年龄、种族、民族和社会人口统计学状况评估患病率。

方法

利用罗切斯特流行病学项目对2020年1月1日居住在美国一个27县区域的86,946名40至59岁女性进行横断面患病率研究。提取诊断计费代码,并使用细化的临床分类系统将其分组为更广泛的疾病类别。按年龄、种族、民族和地区贫困指数四分位数计算424种疾病的患病率。采用逻辑回归分析参与者特征与影响10%或更多研究人群的疾病之间的关联。

结果

28种疾病影响了≥10%的女性,8种疾病在40至59岁之间患病率增加了≥45%(脂质代谢紊乱、高血压、睡眠/觉醒障碍、甲状腺疾病、食管疾病、骨关节炎、肌腱和滑膜疾病以及更年期疾病;所有趋势检验P<0.01)。黑人女性在各年龄段高血压和食管疾病的患病率显著更高(校正P值<0.05)。生活在贫困地区的女性高脂血症、高血压、睡眠/觉醒障碍和食管疾病的患病率显著更高(校正P值<0.05)。生活在贫困程度较低地区的女性在40至44岁时甲状腺疾病患病率显著更高,在50至59岁时更年期疾病患病率显著更高(校正P值<0.05)。

结论

这些数据表明,应更多关注黑人女性和社会经济地位较低的女性,以确保常见的中年疾病得到诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ccb/12147726/527187af5076/meno-32-112-g001.jpg

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