少数民族健康社会脆弱性及其与癌症发病率的关系:一项全国生态调查。

IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL
Abdul R Shour, Amog Jayarangaiah, Ronald Anguzu, David Puthoff, Adedayo Onitilo
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引用次数: 0

摘要

背景:癌症是美国主要的公共卫生问题,特别是在少数民族人群中。区域层面的健康社会决定因素(SDOH)影响癌症结果,但少数民族健康社会脆弱性指数(MHSVI)对县一级癌症发病率的影响尚不清楚。方法:我们分析了卫生保健研究与质量机构2019年3232个县的生态数据。暴露因素包括MHSVI主题:社会经济、家庭组成、少数民族地位/语言、住房/交通、医疗基础设施/获取和医疗脆弱性(连续)。总体MHSVI分为低(0.01 /.25)、中(0.26 /.74)和高(0.75 /1)三个百分位数。结果是癌症病例总数(连续)。协变量包括美国地区和城乡地区。采用STATA/MPv.17对未调整和调整后的负二项回归进行总体加权;P值≤0.05认为有统计学意义。结果:共分析3232个县,平均2817.9例(SD: 7733.5),范围16 ~ 201547例。在未经调整的分析中,所有变量都与癌症病例显著相关。调整后的分析显示,中度人群癌症发病率增高(IRR:0.94, 95%CI:0.92-0.96)。结论:我们的研究突出了MHSVI与县级癌症发病率之间的显著相关性。区域和城乡差异是明显的,强调需要有针对性的干预措施解决SDOH,以减少癌症差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Minority Health Social Vulnerability and Its Association with Cancer Incidence: A Nationwide Ecological Investigation.

Background: Cancer is a major public health concern in the United States, especially among minority populations. Area-level social determinants of health (SDOH) influence cancer outcomes, but the impact of the Minority Health Social Vulnerability Index (MHSVI) on cancer incidence at the county level is less understood.Methods: We analyzed ecological data from the Agency for Health Care Research and Quality for 3,232 counties in 2019. Exposures included MHSVI themes: socioeconomic, household composition, minority status/language, housing/transportation, healthcare infrastructure/access, and medical vulnerability (continuous). Overall MHSVI was categorized into low (.01/.25), moderate (.26/.74), and high (.75/1) percentiles. The outcome was the total number of cancer cases (continuous). Covariates included US regions and rural-urban regions. Unadjusted and adjusted negative binomial regressions with population weighting were performed using STATA/MPv.17; P values ≤0.05 were considered statistically significant.Results: A total of 3,232 counties were analyzed, with an average of 2,817.9 (SD:7,733.5) cancer cases, ranging from 16 to 201,547. All variables were significantly associated with cancer cases in unadjusted analyses. Adjusted analysis showed increased cancer incidence in moderate (IRR:0.94, 95%CI:0.92-0.96, P<0.001) and high (IRR:0.86, 95%CI:0.84-0.88, P<0.001) MHSVI areas compared to low MHSVI areas. Regional differences were observed, with increased cancer incidence in the Northeast (IRR:1.18, 95%CI:1.15-1.22, P<0.001), South (IRR:1.03, 95% CI:1.01-1.05, P<0.001), and West (IRR:0.92, 95%CI:0.90-0.94, P<0.001) compared to the Midwest. Rural areas had a slight increase in cancer incidence compared to urban areas (IRR:1.03, 95%CI:1.01-1.04, P<0.001).Conclusions: Our study highlights the significant association between MHSVI and cancer incidence at the county level. Regional and rural-urban differences were evident, emphasizing the need for targeted interventions addressing SDOH to reduce cancer disparities.

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来源期刊
Clinical Medicine & Research
Clinical Medicine & Research MEDICINE, GENERAL & INTERNAL-
CiteScore
1.80
自引率
7.10%
发文量
25
期刊介绍: Clinical Medicine & Research is a peer reviewed publication of original scientific medical research that is relevant to a broad audience of medical researchers and healthcare professionals. Articles are published quarterly in the following topics: -Medicine -Clinical Research -Evidence-based Medicine -Preventive Medicine -Translational Medicine -Rural Health -Case Reports -Epidemiology -Basic science -History of Medicine -The Art of Medicine -Non-Clinical Aspects of Medicine & Science
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