Sharland M, Atkinson P, Maguire H, Begg N
Paediatric Infectious Diseases Unit, St George's Hospital, London.
Commun Dis Rep CDR Rev. 1997 Oct 17;7(11):R169-72.
The aim of this study was to determine associations between indicators of social deprivation and the uptake of primary immunisation in London. Correlation coefficients were calculated between immunisation coverage in London for each of the 28 inner and outer London district health authorities in November 1991 and a range of possible explanatory variables from small area statistics data from the November 1991 census. The proportions of children under 5 years of age, lone parent families, unemployed members of the workforce, domestic overcrowding, ethnic minorities, and unskilled workforce were correlated significantly with the coverage of primary immunisation for third dose diphtheria (D3) and pertussis (P3) at 12 months. A significant correlation with measles, mumps, and rubella (MMR) at 24 months existed only for lone parent families. Multiple linear regression weighted by population size was used to identify independent predictors of variation in immunisation cover. The proportion of lone parent families in each district health authority was the only significant independent risk factor consistently associated with variation in immunisation coverage for D3, P3, and MMR. The proportion of lone parent families explained 42% of the variation in coverage for D3 in November 1991. This study has identified lone parenthood as an important independent risk factor in London for failure to complete immunisation.
本研究的目的是确定伦敦社会剥夺指标与初级免疫接种率之间的关联。计算了1991年11月伦敦28个内伦敦和外伦敦地区卫生当局各自的免疫接种覆盖率与一系列可能的解释变量之间的相关系数,这些解释变量来自1991年人口普查的小区域统计数据。5岁以下儿童、单亲家庭、劳动力中的失业成员、家庭过度拥挤、少数民族和非熟练劳动力的比例与12个月时白喉第三剂(D3)和百日咳第三剂(P3)的初级免疫接种覆盖率显著相关。仅单亲家庭与24个月时麻疹、腮腺炎和风疹(MMR)的接种率存在显著相关性。采用按人口规模加权的多元线性回归来确定免疫接种覆盖率变化的独立预测因素。每个地区卫生当局中单亲家庭的比例是唯一与D3、P3和MMR免疫接种覆盖率变化始终相关的显著独立风险因素。单亲家庭的比例解释了1991年11月D3覆盖率变化的42%。本研究已确定单亲家庭是伦敦未能完成免疫接种的一个重要独立风险因素。