日常歧视与非裔美国老人较高的住院几率有关。

Brittney S Lange-Maia, Bryan D James, Ana W Capuano, Francine Grodstein, Yi Chen, Lisa L Barnes
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摘要

背景:日常歧视--基于种族等背景特征而受到不公平对待的经历--与人一生中身心健康状况不佳有关。至于非裔美国老年人是否会因遭受更多歧视而住院治疗的几率更高,目前还没有研究:方法:纳入了三项纵向队列研究中居住在社区的参与者(人数=446,年龄在 65 岁以上,具有歧视评分且关联的医疗保险索赔≥12 个月)。住院情况通过医疗保险付费服务报销单进行确认,基线后平均随访 6.2 年(SD:3.7 年):在经年龄、性别、教育程度和收入调整的混合效应序数逻辑回归模型中(结果为每年 0 次、1 次或 2 次以上住院),歧视程度越高,每年住院总次数的几率就越高(每高 1 次的 OR=1.09,95% CI:1.02-1.17)。如果考虑到抑郁症状,结果也类似:结论:在非裔美国老年人中,日常受到的歧视越多,住院治疗的几率就越高。应进一步探究其关联机制,以了解如何减少非裔美国老人的住院率。
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Everyday Discrimination Is Associated With Higher Odds of Hospitalizations Among Older African Americans.

Background: Everyday discrimination-experiences of being treated unfairly based on background characteristics like race-is linked to poor physical and mental health throughout the lifespan. Whether more experiences of discrimination are associated with higher odds of being hospitalized in older African Americans has not been explored.

Methods: Community-dwelling participants from 3 longitudinal cohort studies (N = 446, age 65+ years) with discrimination scores and ≥12 months of linked Medicare claims were included. Hospitalizations were identified using Medicare fee-for-service claims, available for an average of 6.2 (SD: 3.7) years of follow-up after baseline.

Results: In mixed-effects ordinal logistic regression models (outcomes of 0, 1, or 2+ hospitalizations per year) adjusted for age, sex, education, and income, higher discrimination was associated with higher odds of total annual hospitalizations (odds ratio [OR] per point higher = 1.09, 95% confidence intervals [95% CI]: 1.02-1.17). Results were similar when accounting for depressive symptoms.

Conclusions: Higher exposure to everyday discrimination is associated with higher odds of hospitalization among older African Americans. Mechanisms underlying associations should be explored further to understand how hospitalizations may be reduced in older African Americans.

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