Department of Family and Community Medicine, University of California, San Francisco, 3333 California St, Suite 365, San Francisco, CA 94118, USA.
Am J Public Health. 2010 Apr 1;100 Suppl 1(Suppl 1):S186-96. doi: 10.2105/AJPH.2009.166082. Epub 2010 Feb 10.
We aimed to describe socioeconomic disparities in the United States across multiple health indicators and socioeconomic groups.
Using recent national data on 5 child (infant mortality, health status, activity limitation, healthy eating, sedentary adolescents) and 6 adult (life expectancy, health status, activity limitation, heart disease, diabetes, obesity) health indicators, we examined indicator rates across multiple income or education categories, overall and within racial/ethnic groups.
Those with the lowest income and who were least educated were consistently least healthy, but for most indicators, even groups with intermediate income and education levels were less healthy than the wealthiest and most educated. Gradient patterns were seen often among non-Hispanic Blacks and Whites but less consistently among Hispanics.
Health in the United States is often, though not invariably, patterned strongly along both socioeconomic and racial/ethnic lines, suggesting links between hierarchies of social advantage and health. Worse health among the most socially disadvantaged argues for policies prioritizing those groups, but pervasive gradient patterns also indicate a need to address a wider socioeconomic spectrum-which may help garner political support. Routine health reporting should examine socioeconomic and racial/ethnic disparity patterns, jointly and separately.
我们旨在描述美国在多个健康指标和社会经济群体方面的社会经济差异。
使用最近关于 5 项儿童(婴儿死亡率、健康状况、活动受限、健康饮食、久坐不动的青少年)和 6 项成人(预期寿命、健康状况、活动受限、心脏病、糖尿病、肥胖)健康指标的国家数据,我们检查了多个收入或教育类别中的指标率,包括整体和种族/族裔群体内的情况。
收入最低和受教育程度最低的人健康状况始终最差,但对于大多数指标,即使是收入和教育程度中等的群体,也不如最富裕和受教育程度最高的群体健康。非西班牙裔黑人和白人中经常出现梯度模式,但西班牙裔中则不太一致。
美国的健康状况通常,但并非总是如此,沿着社会经济和种族/族裔两条线强烈地呈现模式,表明社会优势等级与健康之间存在联系。最处于社会劣势地位的人群的健康状况更差,这表明需要优先考虑这些群体的政策,但普遍存在的梯度模式也表明需要解决更广泛的社会经济范围-这可能有助于获得政治支持。常规健康报告应共同和分别检查社会经济和种族/族裔差异模式。