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基于调查数据的综合社会经济剥夺指数:与健康结果及差异的关联

A composite socioeconomic deprivation index from survey data: associations with health outcomes and disparities.

作者信息

Gupta Sonali, Lam Vincent, Jordan I King, Mariño-Ramírez Leonardo

机构信息

National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA.

IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia, USA.

出版信息

medRxiv. 2024 Oct 4:2024.10.04.24314904. doi: 10.1101/2024.10.04.24314904.

Abstract

Socioeconomic deprivation - defined as a lack of social, economic and material resources - is associated with poor health outcomes and health disparities between population groups. The Research Program is a longitudinal cohort study of diverse participants from the United States, with demographic and social determinants of health data gleaned from participant surveys and health outcome data derived from electronic health records. We developed a composite index of socioeconomic deprivation (iSDI) using a cohort of 202,919 participants - based on education, employment, health insurance, housing, and income data - and we associated iSDI with health outcomes and disparities. iSDI is significantly associated with 970 out of 1,755 (55.3%) health conditions modeled here, with 661 positive and 309 negative associations. Mental disorders and circulatory diseases show the highest proportion of positive associations with iSDI, whereas neoplasms and congenital anomalies show the highest proportion of negative associations. Black (0.55) and Hispanic (0.52) participants show higher average iSDI values compared to White (0.29) and Asian (0.24) participants; although the majority of iSDI variation is found within (76.8%) rather than between (23.2%) groups. iSDI mediates 213 out of 399 (53.5%) Black health disparity conditions and 173 out of 297 (58.2%) Hispanic health disparity conditions. The composite socioeconomic deprivation index (iSDI) developed here is associated with a wide variety of health outcomes and disparities in the cohort, and we make participant iSDI values available on the Researcher Workbench to support future studies on social determinants of health.

摘要

社会经济剥夺——定义为缺乏社会、经济和物质资源——与健康状况不佳以及人群之间的健康差异有关。该研究项目是一项针对来自美国的不同参与者的纵向队列研究,从参与者调查中收集健康数据的人口统计学和社会决定因素,并从电子健康记录中获取健康结果数据。我们基于202,919名参与者的队列,利用教育、就业、健康保险、住房和收入数据,开发了一个社会经济剥夺综合指数(iSDI),并将iSDI与健康结果和差异联系起来。在此建模的1755种健康状况中,有970种(55.3%)与iSDI显著相关,其中661种为正相关,309种为负相关。精神障碍和循环系统疾病与iSDI的正相关比例最高,而肿瘤和先天性异常与iSDI的负相关比例最高。与白人(0.29)和亚洲人(0.24)参与者相比,黑人(0.55)和西班牙裔(0.52)参与者的iSDI平均值得分更高;尽管iSDI的大部分差异存在于组内(76.8%)而非组间(23.2%)。iSDI介导了399种黑人健康差异状况中的213种(53.5%)和297种西班牙裔健康差异状况中的173种(58.2%)。这里开发的社会经济剥夺综合指数(iSDI)与该队列中的多种健康结果和差异相关,我们在研究人员工作台上提供参与者的iSDI值,以支持未来关于健康社会决定因素的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a0/11722465/7511ea6f4ad4/nihpp-2024.10.04.24314904v1-f0001.jpg

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