VCU Center on Human Needs, Virginia Commonwealth University, Richmond, VA 23298-0251, USA.
Am J Public Health. 2010 Apr;100(4):750-5. doi: 10.2105/AJPH.2009.165142. Epub 2010 Feb 18.
We estimated how many deaths would be averted if the entire population of Virginia experienced the mortality rates of the 5 most affluent counties or cities.
Using census data and vital statistics for the years 1990 through 2006, we applied the mortality rates of the 5 counties/cities with the highest median household income to the populations of all counties and cities in the state.
If the mortality rates of the reference population had applied to the entire state, 24.3% of deaths in Virginia from 1990 through 2006 (range = 21.8%-28.1%) would not have occurred. An annual mean of 12 954 deaths would have been averted (range = 10 548-14 569), totaling 220 211 deaths from 1990 through 2006. In some of the most disadvantaged areas of the state, nearly half of deaths would have been averted.
Favorable conditions that exist in areas with high household incomes exert a major influence on mortality rates. The corollary-that health suffers when society is exposed to economic stresses-is especially timely amid the current recession. Further research must clarify the extent to which individual-level factors (e.g., earnings, education, race, health insurance) and community characteristics can improve health outcomes.
如果弗吉尼亚州的所有居民都享有 5 个最富裕的县或市的死亡率,那么将会有多少人避免死亡。
利用 1990 年至 2006 年的人口普查数据和生命统计数据,我们将收入中位数最高的 5 个县/市的死亡率应用于该州所有县和市的人口。
如果参考人群的死亡率适用于整个州,那么弗吉尼亚州 1990 年至 2006 年期间(范围为 21.8%至 28.1%)有 24.3%的死亡将不会发生。每年平均可避免 12954 人死亡(范围为 10548-14569),从 1990 年至 2006 年共可避免 220211 人死亡。在该州一些最贫困的地区,近一半的死亡人数将得到避免。
高收入地区存在的有利条件对死亡率有重大影响。当社会面临经济压力时,健康状况会受到影响,这一观点在当前经济衰退时期尤为及时。进一步的研究必须阐明个人层面的因素(如收入、教育、种族、医疗保险)和社区特征在多大程度上可以改善健康结果。