Vázquez-Vizoso F, Castilla J, Pollán M, López-Abente G
National Centre for Epidemiology, Madrid, Spain.
Soc Sci Med. 1993 Aug;37(3):413-7. doi: 10.1016/0277-9536(93)90271-5.
After discussing the comparative effectiveness of different measures of dispersion used as indices of inequality, the Weighted Coefficient of Variation is proposed as an appropriate indicator of geographical inequality attending infant death. Furthermore, this paper proposes a methodology based on simple linear regression to be employed for the purposes of assessing the percentage of the observed change in said inequality over any given period, as is required by the terms of Target 1 of the WHO policy document "Health for All by the Year 2000". To this end, trends in Infant, Neonatal, Postneonatal and Perinatal Mortality in Spain for the period 1975-1986 have been analysed. For the 12 years examined, the Average Spanish Rate for these four indicators fell by over 50%. We observed a statistically significant decrease (34.8%) in geographical inequalities in the case of Postneonatal Mortality. However for the same period, geographical inequalities in Perinatal Mortality showed an important and significant rise (79.33%). It is suggested that, where Spain is concerned, it is Perinatal Mortality which should be assigned priority status for monitoring purposes. A plan of action should be drawn up, duly targeted at reducing geographical inequalities in health services, in the mother-and-child care sector above all.
在讨论了用作不平等指数的不同离散度测量方法的比较有效性之后，提出加权变异系数作为婴儿死亡地区不平等的合适指标。此外，本文提出了一种基于简单线性回归的方法，用于评估在任何给定时期内所述不平等观察变化的百分比，这是世界卫生组织政策文件《2000年人人健康》目标1条款所要求的。为此，分析了1975 - 1986年期间西班牙婴儿、新生儿、新生儿后期和围产期死亡率的趋势。在研究的12年中，这四项指标的西班牙平均率下降了50%以上。我们观察到，新生儿后期死亡率的地区不平等有统计学意义的下降（34.8%）。然而，同期围产期死亡率的地区不平等出现了重要且显著的上升（79.33%）。有人建议，就西班牙而言，围产期死亡率应被列为监测的优先事项。应制定一项行动计划，尤其要切实针对减少母婴护理部门卫生服务中的地区不平等。
