Armstrong D, Barnett E, Casper M, Wing S
Department of Epidemiology, SPH, University at Albany, Rensselaer, NY 12144-3456.
Ann Epidemiol. 1998 Apr;8(3):184-91. doi: 10.1016/s1047-2797(97)00202-0.
To examine the association between coronary heart disease (CHD) mortality, economic and medical resources, and county occupational structure.
U.S. counties were classified into five occupational structure categories based on the percentage of workers in white-collar occupations. Directly age-adjusted CHD mortality rates (from vital statistics and Census data) and economic and medical care data (from Census and Area Resource File data) were calculated for each occupational structure category. Participants were black and white, men and women, aged 35-64 years, in the U.S. during 1980-88. CHD mortality rates and economic and medical care data were compared across occupational structure categories.
Among blacks, CDH rates were highest in counties with intermediate levels of occupational structure; rates among whites were inversely associated with occupational structure. Per capita levels of income and numbers of medical-care providers were positively associated with occupational structure.
Strategies to improve the resources of disadvantaged communities and the access of black workers to local occupational opportunities may be important for CHD prevention in high risk populations.
研究冠心病（CHD）死亡率、经济和医疗资源与县职业结构之间的关联。
根据白领职业工人的百分比，将美国各县分为五个职业结构类别。计算每个职业结构类别的直接年龄调整后的冠心病死亡率（来自生命统计和人口普查数据）以及经济和医疗数据（来自人口普查和区域资源文件数据）。参与者为1980 - 1988年期间美国35 - 64岁的黑人与白人、男性与女性。比较各职业结构类别之间的冠心病死亡率以及经济和医疗数据。
在黑人中，职业结构处于中等水平的县的冠心病发病率最高；白人中的发病率与职业结构呈负相关。人均收入水平和医疗服务提供者数量与职业结构呈正相关。
改善弱势社区资源以及黑人劳动者获得当地职业机会的策略，对于高危人群的冠心病预防可能至关重要。
