LaVeist Thomas, Thorpe Roland, Bowen-Reid Terra, Jackson John, Gary Tiffany, Gaskin Darrell, Browne Dorothy
Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway Suite 441, Baltimore, MD 21205, USA.
J Urban Health. 2008 Jan;85(1):11-21. doi: 10.1007/s11524-007-9226-y. Epub 2007 Nov 13.
Progress in understanding the nature of health disparities requires data that are race-comparative while overcoming confounding between race, socioeconomic status, and segregation. The Exploring Health Disparities in Integrated Communities (EHDIC) study is a multisite cohort study that will address these confounders by examining the nature of health disparities within racially integrated communities without racial disparities in socioeconomic status. Data consisted of a structured questionnaire and blood pressure measurements collected from a sample of the adult population (age 18 and older) of two racially integrated contiguous census tracts. This manuscript reports on baseline results from the first EHDIC site, a low-income urban community in southwest Baltimore, Maryland (EHDIC-SWB). In the adjusted models, African Americans had lower rates of smoking and fair or poor self-rated health than whites, but no race differences in obesity, drinking, or physical inactivity. Our findings indicate that accounting for race differences in exposure to social conditions reduces or eliminates some health-related disparities. Moreover, these findings suggest that solutions to the seemingly intractable health disparities problem that target social determinants may be effective, especially those factors that are confounded with racial segregation. Future research in the area of health disparities should seek ways to account for confounding from SES and segregation.
要深入理解健康差异的本质,就需要有能进行种族比较的数据,同时要克服种族、社会经济地位和隔离之间的混杂因素。综合社区健康差异探索(EHDIC)研究是一项多地点队列研究,该研究将通过考察社会经济地位不存在种族差异的种族融合社区内健康差异的本质来解决这些混杂因素。数据包括一份结构化问卷以及从两个种族融合的相邻普查区的成年人口样本(年龄在18岁及以上)中收集的血压测量值。本手稿报告了EHDIC第一个研究地点的基线结果,该地点位于马里兰州巴尔的摩西南部的一个低收入城市社区(EHDIC - SWB)。在调整后的模型中,非裔美国人的吸烟率以及自我评定健康状况为一般或较差的比例低于白人,但在肥胖、饮酒或缺乏身体活动方面不存在种族差异。我们的研究结果表明,考虑到社会状况暴露方面的种族差异,会减少或消除一些与健康相关的差异。此外,这些研究结果表明,针对社会决定因素的看似棘手的健康差异问题的解决方案可能是有效的,尤其是那些与种族隔离混杂在一起的因素。健康差异领域的未来研究应寻求方法来考虑社会经济地位和隔离造成的混杂因素。