Department of Health Behavior and Health Education, School of Public Health, and the Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA.
Am J Public Health. 2011 Apr;101(4):720-9. doi: 10.2105/AJPH.2010.195537.
Black working-aged residents of urban high-poverty areas suffered severe excess mortality in 1980 and 1990. Our goal in this study was to determine whether this trend persisted in 2000.
We analyzed death certificate and census data to estimate age-standardized all-cause and cause-specific mortality among 16- to 64-year-old Blacks and Whites nationwide and in selected urban and rural high-poverty areas.
Urban men's mortality rate estimates peaked in 1990 and declined between 1990 and 2000 back to or below 1980 levels. Evidence of excess mortality declines among urban or rural women and among rural men was modest, with some increases. Between 1980 and 2000, there was little decline in chronic disease mortality among men and women in most areas, and in some instances there were increases.
In 2000, despite improved economic conditions, working-age residents of the study areas still died disproportionately of early onset of chronic disease, suggesting an entrenched burden of disease and unmet health care needs. The lack of consistent improvement in death rates among working-age residents of high-poverty areas since 1980 necessitates reflection and concerted action given that sustainable progress has been elusive for this age group.
1980 年和 1990 年，城市贫困地区的年轻黑人工作者死亡率过高。本研究旨在确定这一趋势在 2000 年是否持续。
我们分析了死亡证明和人口普查数据，以估计全国范围内 16 至 64 岁的黑人和白人的全因和特定原因死亡率，以及在选定的城市和农村高贫困地区的死亡率。
城市男性的死亡率估计在 1990 年达到峰值，并在 1990 年至 2000 年期间下降，回到或低于 1980 年的水平。城市或农村女性以及农村男性的过度死亡减少的证据并不明显，有些地区有所增加。在大多数地区，1980 年至 2000 年间，男性和女性的慢性病死亡率几乎没有下降，在某些情况下甚至有所上升。
尽管经济条件有所改善，但在 2000 年，研究地区的年轻工作者仍不成比例地死于慢性病的早期发作，这表明疾病负担根深蒂固，医疗需求未得到满足。自 1980 年以来，高贫困地区年轻工作者的死亡率一直没有持续改善，这需要反思和协调行动，因为该年龄段的可持续进展一直难以实现。
