Gissler Mika, Rahkonen Ossi, Mortensen Laust, Arntzen Annett, Cnattingius Sven, Nybo Andersen Anne-Marie, Hemminki Elina
THL National Institute for Health and Welfare, P.O. BOX 30, 00271 Helsinki, Finland.
Scand J Public Health. 2009 Jun;37(4):340-6. doi: 10.1177/1403494809103905. Epub 2009 Mar 13.
Unlike the situation for infant and adult mortality, there are only a few studies on child and adolescent mortality. The purpose of this study was to examine sex differences in child and adolescent mortality by age and cohort in four Nordic countries over a 20-year period.
Data on all live-born children were received from national population-covering birth registries from 1981 to 2000 (Denmark, n = 1,184,926; Finland, n = 841,470 (from 1987 to 2000); Norway, n = 1,090,127; and Sweden, n = 1,961,911). Data on mortality and causes of death until the age of 20 years were received from the national cause-of-death registers.
The overall mortality rates were higher in Denmark and Norway than in Finland and Sweden, among both boys and girls, and the difference between countries increased over time. In all countries, boys had higher mortality rates than girls. Overall, the sex difference was larger in Denmark and Norway (36% and 33% higher, respectively) than in Finland and Sweden (both 24%). The sex differences were more pronounced for deaths of those aged 5-19 years than for those aged 0-4 years. Twelve per cent of all deaths among boys and 10% of those among girls were due to external causes, mainly unintentional injury deaths or intentional deaths. For children and adolescents aged 5-19 years, the corresponding figures were 43% for boys and 35% for girls.
Boys have excess mortality, but the sex difference is lower in countries with lower mortality. Boys' excess mortality was only partly accounted for by deaths from external causes. Avoidable deaths and causes of death need further investigation.
与婴儿和成人死亡率的情况不同，关于儿童和青少年死亡率的研究较少。本研究的目的是在20年期间，考察四个北欧国家儿童和青少年死亡率在年龄和队列方面的性别差异。
从1981年至2000年的全国人口覆盖出生登记处获取所有活产儿童的数据（丹麦，n = 1,184,926；芬兰，n = 841,470（1987年至2000年）；挪威，n = 1,090,127；瑞典，n = 1,961,911）。从国家死亡原因登记处获取直至20岁的死亡率和死亡原因数据。
丹麦和挪威的总体死亡率高于芬兰和瑞典，无论男孩还是女孩皆是如此，且国家间的差异随时间增加。在所有国家，男孩的死亡率均高于女孩。总体而言，丹麦和挪威的性别差异更大（分别高36%和33%），高于芬兰和瑞典（均为24%）。5 - 19岁人群的性别差异比0 - 4岁人群更为明显。男孩所有死亡中的12%以及女孩中的10%是由外部原因导致的，主要是意外伤害死亡或故意死亡。对于5 - 19岁的儿童和青少年，相应的数字男孩为43%，女孩为35%。
男孩死亡率偏高，但在死亡率较低的国家性别差异较小。男孩死亡率偏高仅部分归因于外部原因导致的死亡。可避免的死亡及死亡原因需要进一步调查。
