衡量1987年至2000年期间艾滋病毒/艾滋病、心脏病和恶性肿瘤对美国预期寿命的影响。
Measuring the impact of HIV/AIDS, heart disease and malignant neoplasms on life expectancy in the USA from 1987 to 2000.
作者信息
Lai D J, Tarwater P M, Hardy R J
机构信息
School of Public Health, The University of Texas, Houston, TX 77030, USA.
出版信息
Public Health. 2006 Jun;120(6):486-92. doi: 10.1016/j.puhe.2005.12.009. Epub 2006 May 26.
OBJECTIVES
Quantifying the impact of a disease on society is an important issue for setting priorities for better allocation of healthcare resources and for evaluating the effectiveness of prevention and control of the disease.
STUDY DESIGN
The potential gains in life expectancy due to the elimination of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), heart disease and malignant neoplasms were compared for the US population by age and ethnicity from 1987 to 2000.
METHODS
The potential gain in life expectancy after hypothetical elimination of cause-specific deaths is an effective indicator of measuring the impact of a disease on a population. Official age-specific mortality rates, by ethnicity, due to HIV/AIDS, heart disease and malignant neoplasms of the US population from the National Center for Health Statistics were used, and multiple decremental life tables were constructed to find the corresponding potential gains in life expectancy.
RESULTS
The potential gains in life expectancy for the US population at birth by complete elimination of HIV/AIDS, heart disease and malignant neoplasms were 0.14, 3.71 and 3.06 years in 1987, respectively. In 1995, the potential gain in life expectancy due to the elimination of HIV/AIDS increased from 0.14 years in 1987 and achieved its highest value (0.41 years), whereas the elimination of heart disease and malignant neoplasms led to potential gains in life expectancy of 3.05 and 3.10 years, respectively. Since 1995, the potential gains in life expectancy at birth by eliminating deaths from HIV/AIDS and heart disease have decreased to 0.13 and 2.67 years, respectively, in 2000. However, the potential gain in life expectancy due to elimination of malignant neoplasms remained relatively stable (3.01 years in 2000). It is well known that HIV/AIDS tends to have a greater impact on people of working age, whereas heart disease and malignant neoplasms have a greater impact on people over 65 years of age. To measure the impact of these diseases on life expectancy in people of working age, a partial multiple decremental life table was constructed and the potential gains in life expectancy were computed by partial or complete elimination of various causes of death during the working years. shows the impact on life expectancy of the US working-age population by eliminating deaths from HIV/AIDS, heart disease and malignant neoplasms by race and sex groups.
CONCLUSIONS
Since 1995, there has been a rapid reduction in the burden of HIV/AIDS on the life expectancy for the US population, especially for black males of working age. These results could provide useful information when evaluating public health improvements and allocating resources for future disease control programmes.
目标
量化一种疾病对社会的影响是确定医疗资源更优分配的优先事项以及评估该疾病预防和控制效果的重要问题。
研究设计
比较了1987年至2000年美国不同年龄和种族人群因消除人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)、心脏病和恶性肿瘤而在预期寿命方面的潜在收益。
方法
假设消除特定病因死亡后预期寿命的潜在增加是衡量一种疾病对人群影响的有效指标。使用了美国国家卫生统计中心提供的按种族划分的美国人群因HIV/AIDS、心脏病和恶性肿瘤的官方特定年龄死亡率,并构建了多重递减寿命表以找出预期寿命的相应潜在增加。
结果
1987年,完全消除HIV/AIDS、心脏病和恶性肿瘤后,美国出生时人群的预期寿命潜在增加分别为0.14年、3.71年和3.06年。1995年,因消除HIV/AIDS导致的预期寿命潜在增加从1987年的0.14年增加到最高值(0.41年),而消除心脏病和恶性肿瘤分别导致预期寿命潜在增加3.05年和3.10年。自1995年以来,2000年因消除HIV/AIDS和心脏病死亡导致的出生时预期寿命潜在增加分别降至0.13年和2.67年。然而,因消除恶性肿瘤导致的预期寿命潜在增加保持相对稳定(2000年为3.01年)。众所周知,HIV/AIDS往往对劳动年龄人群影响更大,而心脏病和恶性肿瘤对65岁以上人群影响更大。为了衡量这些疾病对劳动年龄人群预期寿命的影响,构建了部分多重递减寿命表,并通过部分或完全消除工作期间各种死因来计算预期寿命的潜在增加。展示了按种族和性别群体消除HIV/AIDS、心脏病和恶性肿瘤死亡对美国劳动年龄人群预期寿命的影响。
结论
自1995年以来,HIV/AIDS对美国人群预期寿命的负担迅速减轻,尤其是对劳动年龄的黑人男性。这些结果在评估公共卫生改善情况和为未来疾病控制项目分配资源时可提供有用信息。