Regidor Enrique, Calle M Elisa, Navarro Pedro, Domínguez Vicente
Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid Spain.
Eur J Epidemiol. 2003;18(5):395-400. doi: 10.1023/a:1024296932294.
This study examines the association between education and mortality from specific causes of death based on mortality records for 1996 and 1997, and 1996 population census data from the Region of Madrid (Spain). Poisson regression models were used to estimate the percentage increase in mortality associated with 1 year less education. The percentage increases in mortality from stomach cancer, lung, bladder and liver cancers, for aids, chronic obstructive pulmonary disease, pneumonia and influenza, and chronic liver disease and cirrhosis were higher in men than in women, whereas the percentage increases in mortality from colon cancer, diabetes mellitus, ischemic heart disease and nephritis, nephrosis and nephrotic syndrome were higher in women. The results found for some causes of death--lung cancer, ischemic heart disease, diabetes mellitus and chronic obstructive pulmonary disease--reflect the variations by educational level in the prevalence of lifestyle-related risk factors in men and women. Various hypotheses have been suggested for other causes of death, but it is not known why the magnitude of the association between education and mortality from some causes of death differs between men and women. Future studies of this subject may provide some clues as to the underlying mechanisms of this association.
本研究基于1996年和1997年的死亡率记录以及西班牙马德里地区1996年的人口普查数据,考察教育与特定死因死亡率之间的关联。采用泊松回归模型来估计受教育年限每减少1年所导致的死亡率上升百分比。男性因胃癌、肺癌、膀胱癌和肝癌、艾滋病、慢性阻塞性肺疾病、肺炎和流感以及慢性肝病和肝硬化导致的死亡率上升百分比高于女性,而女性因结肠癌、糖尿病、缺血性心脏病以及肾炎、肾病和肾病综合征导致的死亡率上升百分比更高。对于某些死因——肺癌、缺血性心脏病、糖尿病和慢性阻塞性肺疾病——所发现的结果反映了男性和女性与生活方式相关的危险因素患病率在教育水平上的差异。对于其他死因,已经提出了各种假设,但尚不清楚为何教育与某些死因死亡率之间关联的程度在男性和女性之间存在差异。关于该主题的未来研究可能会为这种关联的潜在机制提供一些线索。