Department of Epidemiology and Public Health, MD/PhD Program, University of Miami Miller School of Medicine, Miami, Florida 33101, USA.
J Surg Res. 2011 Mar;166(1):28-31. doi: 10.1016/j.jss.2010.04.029. Epub 2010 May 15.
Unintentional injury is a leading cause of preventable mortality in elderly populations and is most often related to accidental falls and motor vehicle accidents. Hispanic ethnicity has been previously associated with decreased risk of accidental fall death as well as improved outcomes in other health states, the "Hispanic paradox." A timely analysis of national data with consideration for multiple injury types and age could provide insight into this epidemiologic phenomenon and help guide the use of prevention efforts.
Search of the Center for Disease Control's WISQARS database was performed to identify the number of fatalities in the U.S. between 2003 and 2006 by age group, gender, Hispanic ethnicity, and injury type. Total U.S. population and group populations for the years examined were obtained from the U.S. Census Bureau's American Community Survey for each year. Mortality was calculated as fatalities over the total group population for the years examined.
Independent of gender and age group, elderly Hispanics were at decreased risk of death from accidental fall or as an occupant in a motor vehicle accident, but increased risk of pedestrian fatality compared with white-NH.
The reduced fall and occupant mortality seen in elderly Hispanic populations may come at the cost of increased pedestrian-related mortality. This is consistent with and likely reflects differences in culture, socioeconomic status, and geographic distribution for the U.S. Hispanic population. Effective targeting of injury prevention programs, especially community based, should consider the role of Hispanic ethnicity and its impact on lifestyle.
意外伤害是老年人死亡的主要原因,且主要与意外跌倒和机动车事故有关。西班牙裔族群此前与意外跌倒死亡率降低以及其他健康状况的改善结果相关,这就是“西班牙裔悖论”。对考虑多种损伤类型和年龄的全国性数据进行及时分析,可以深入了解这一流行病学现象,并有助于指导预防工作的开展。
对疾病控制与预防中心的 WISQARS 数据库进行检索,以确定 2003 年至 2006 年期间按年龄组、性别、西班牙裔族群和损伤类型在美国发生的死亡人数。每年的美国总人口和群体人口数据均从美国人口普查局的美国社区调查中获取。将每年的死亡人数除以总群体人口,计算死亡率。
无论性别和年龄组如何,与白人非西班牙裔族群相比,老年西班牙裔族群因意外跌倒或作为机动车事故的乘客而死亡的风险降低,但因行人死亡的风险增加。
与白人非西班牙裔族群相比,老年西班牙裔族群跌倒和乘客死亡率降低,这可能是以增加行人相关死亡率为代价的。这与美国西班牙裔族群的文化、社会经济地位和地域分布差异一致,并且可能反映了这些差异。有效的伤害预防计划,特别是社区为基础的计划,应考虑西班牙裔族群的作用及其对生活方式的影响。