Newacheck P W, Butler L H, Harper A K, Piontkowski D L, Franks P E
Med Care. 1980 Dec;18(12):1165-76. doi: 10.1097/00005650-198012000-00002.
Little research has been directed toward an examination of the health needs of low-income Americans in relation to major governmental medical care programs designed originally to narrow the health gap between "poor" and "nonpoor." Analysis of unpublished data from the 1977 Health Interview Survey of the National Center for Health Statistics shows that about 75 per cent of the gap in restricted activity days and bed disability days--two common measures of the impact of ill-health--between "poor" and "nonpoor" populations is attributable to greater prevalence and severity of activity-limiting chronic conditions among low-income people. Although both income groups report similar types of chronic conditions resulting in activity limitation, the prevalence of all major chronic conditions is greater in the low-income population. Approximately 25 per cent of the low-income population bears the burden of these conditions; the majority of the "poor" report disability day levels similar to the "nonpoor." The substantial impact of chronic conditions should be an important consideration in meeting the health needs of the low-income population. Current government programs, such as Medicare and medicaid, however, are designed primarily to pay for acute care received in hospitals and in physicians' offices.
针对低收入美国人的健康需求与最初旨在缩小“贫困”和“非贫困”人群健康差距的主要政府医疗保健项目之间的关系，所开展的研究很少。对国家卫生统计中心1977年健康访谈调查的未发表数据进行分析表明，在“贫困”和“非贫困”人群之间，受限活动天数和卧床残疾天数（衡量健康不佳影响的两个常用指标）差距的约75% 可归因于低收入人群中导致活动受限的慢性病患病率更高和病情更严重。尽管两个收入群体报告的导致活动受限的慢性病类型相似，但所有主要慢性病在低收入人群中的患病率更高。约25% 的低收入人群承受着这些疾病的负担；大多数“贫困人口”报告的残疾天数水平与“非贫困人口”相似。慢性病的重大影响在满足低收入人群的健康需求时应作为一个重要考虑因素。然而，当前的政府项目，如医疗保险和医疗补助，主要是为支付在医院和医生办公室接受的急性护理费用而设计的。
