Corti M C, Guralnik J M, Ferrucci L, Izmirlian G, Leveille S G, Pahor M, Cohen H J, Pieper C, Havlik R J
Epidemiology, Demography, and Biometry Program, National Institutes of Health, Bethesda, Md., USA.
Am J Public Health. 1999 Mar;89(3):308-14. doi: 10.2105/ajph.89.3.308.
This cohort study evaluated racial differences in mortality among Blacks and Whites 65 years and older.
A total of 4136 men and women (1875 Whites and 2261 Blacks) living in North Carolina were interviewed in 1986 and followed up for mortality until 1994. Hazard ratios (HRs) for all-cause and cause-specific mortality were calculated, with adjustment for sociodemographic and coronary heart disease (CHD) risk factors.
Black persons had higher mortality rates than Whites at young-old age (65-80 years) but had significantly lower mortality rates after age 80. Black persons age 80 or older had a significantly lower risk of all-cause mortality (HR of Blacks vs Whites, 0.75; 95% confidence interval [CI] = 0.62, 0.90) and of CHD mortality (HR 0.44: 95% CI = 0.30, 0.66). These differences were not observed for other causes of death.
Racial differences in mortality are modified by age. This mortality crossover could be attributed to selective survival of the healthiest oldest Blacks or to other biomedical factors affecting longevity after age 80. Because the crossover was observed for CHD deaths only, age overreporting by Black older persons seems an unlikely explanation of the mortality differences.
这项队列研究评估了65岁及以上黑人和白人在死亡率上的种族差异。
1986年,对居住在北卡罗来纳州的4136名男性和女性(1875名白人,2261名黑人)进行了访谈,并对其进行随访直至1994年,以了解死亡率情况。计算了全因死亡率和特定病因死亡率的风险比(HRs),并对社会人口统计学和冠心病(CHD)风险因素进行了调整。
在年轻老年人(65 - 80岁)中,黑人的死亡率高于白人,但在80岁以后,黑人的死亡率显著低于白人。80岁及以上的黑人全因死亡率(黑人与白人的HR为0.75;95%置信区间[CI]=0.62,0.90)和冠心病死亡率(HR 0.44:95% CI = 0.30,0.66)的风险显著较低。在其他死因中未观察到这些差异。
死亡率的种族差异会因年龄而改变。这种死亡率交叉现象可能归因于最健康的老年黑人的选择性生存,或者归因于影响80岁以后寿命的其他生物医学因素。由于仅在冠心病死亡中观察到交叉现象,因此老年黑人年龄报告过高似乎不太可能解释死亡率差异。