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Preconception Health Indicators: A Comparison Between Non-Appalachian and Appalachian Women

机译：偏见健康指标：非阿巴拉契亚和阿巴拉契亚女性之间的比较

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To compare preconception health indicators (PCHIs) among non-pregnant women aged 18–44 years residing in Appalachian and non-Appalachian counties in 13 U.S. states. Data from the 1997–2005 Behavioral Risk Factor Surveillance System were used to estimate the prevalence of PCHIs among women in states with ≥1 Appalachian county. Counties were classified as Appalachian (n = 36,496 women) or non-Appalachian (n = 88,312 women) and Appalachian counties were categorized according to economic status. Bivariate and multivariable logistic regression models examined differences in PCHIs among women by (1) Appalachian residence, and (2) economic classification. Appalachian women were younger, lower income, and more often white and married compared to women in non-Appalachia. Appalachian women had significantly higher odds of reporting <high school education (adjusted odds ratio (AOR) 1.19, 95 % confidence interval (CI) 1.10–1.29), fair/poor health (AOR 1.14, 95 % CI 1.06–1.22), no health insurance (AOR 1.12, 95 % CI 1.05–1.19), no annual checkup (AOR 1.12, 95 % CI 1.04–1.20), no recent Pap test (AOR 1.20, 95 % CI 1.08–1.33), smoking (AOR 1.08, 95 % CI 1.03–1.14),<5 daily fruits/vegetables (AOR 1.11, 95 % CI 1.02–1.21), and overweight/obesity (AOR 1.05, 95 % CI 1.01–1.09). Appalachian women in counties with weaker economies had significantly higher odds of reporting less education, no health insurance, <5 daily fruits/vegetables, overweight/obesity, and poor mental health compared to Appalachian women in counties with the strongest economies. For many PCHIs, Appalachian women did not fare as well as non-Appalachians. Interventions sensitive to Appalachian culture to improve preconception health may be warranted for this population.
机译：比较居住在美国13个州阿巴拉契亚州和非阿巴拉契亚县的18-44岁非怀孕妇女的孕前健康指标（PCHI）。使用1997-2005年行为危险因素监测系统的数据来估计阿巴拉契亚县≥1州的妇女中PCHI的患病率。县分为阿巴拉契亚县（n = 36,496名妇女）或非阿巴拉契亚县（n = 88,312名妇女），阿巴拉契亚县根据经济状况进行分类。双变量和多变量logistic回归模型通过（1）阿巴拉契亚式居住地和（2）经济分类检查了女性之间的PCHI差异。与非阿巴拉契亚妇女相比，阿巴拉契亚妇女年轻，收入较低，白人和已婚妇女更多。阿巴拉契亚妇女报告高中学历的几率显着更高（调整后的优势比（AOR）1.19，95％的置信区间（CI）1.10-1.29），健康状况良好/差（AOR 1.14，95％CI 1.06-1.22），没有健康保险（AOR 1.12，95％CI 1.05–1.19），无年度检查（AOR 1.12，95％CI 1.04–1.20），无近期巴氏试验（AOR 1.20，95％CI 1.08–1.33），吸烟（AOR 1.08， 95％CI 1.03–1.14），<5日常水果/蔬菜（AOR 1.11，95％CI 1.02–1.21）和超重/肥胖症（AOR 1.05，95％CI 1.01–1.09）。与经济实力最强的县的阿巴拉契亚妇女相比，经济较弱的县的阿巴拉契亚妇女报告较少的教育，没有医疗保险，每天水果/蔬菜<5，超重/肥胖和心理健康状况差的几率要高得多。对于许多PCHI而言，阿巴拉契亚妇女的票价不及非阿巴拉契亚妇女。该人群可能需要对阿巴拉契亚文化敏感的干预措施以改善受孕前的健康状况。

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