Lopez A D
Division of Epidemiological Surveillance and Health Situation and Trend Assessment, World Health Organization, Geneva.
World Health Stat Q. 1990;43(2):105-14.
The developed countries are often viewed as being relatively homogeneous in terms of health conditions. This is not the case, however. Whilst the overall level of life expectancy in these countries (73.7 years) is well in excess of that observed in the majority of developing countries, there are nonetheless very substantial differences in health status among and between the developed countries. Female life expectancy is typically 6-8 years longer than that of males. The gap in life expectancy between Japan and some countries of Northern Europe, on the one hand, and the nations of Eastern Europe on the other, is of the same order of magnitude. Of the 11 million deaths reported in the developed countries each year, roughly 5.5 million or almost exactly 50% are attributable to cardiovascular diseases. Of these deaths, 2.4 million are coded to ischaemic heart disease and 1.5 million to stroke (cerebrovascular disease). Cancer (all forms) accounts for 2.3 million deaths (21%), 500,000 of which are due to lung cancer alone. External causes of death claim 750,000 lives each year in the developed countries, with suicide and motor-vehicle accidents each accounting for around 180,000 deaths. This pattern of mortality, when viewed in conjunction with the epidemiological evidence about the principal risk factors associated with these causes of death, strongly suggests that national health-for-all strategies must continue to emphasize individual health consciousness as the primary means of achieving national health goals.
发达国家在健康状况方面通常被视为相对同质化。然而,实际情况并非如此。虽然这些国家的总体预期寿命(73.7岁)远高于大多数发展中国家,但发达国家之间以及内部的健康状况仍存在非常大的差异。女性预期寿命通常比男性长6至8岁。一方面,日本和北欧一些国家与另一方面的东欧国家之间的预期寿命差距相当大。在发达国家每年报告的1100万例死亡中,约550万例(几乎正好占50%)可归因于心血管疾病。在这些死亡病例中,240万例被归类为缺血性心脏病,150万例为中风(脑血管疾病)。癌症(所有类型)导致230万例死亡(21%),其中仅肺癌就导致50万例死亡。在发达国家,外部死因每年导致75万人死亡,自杀和机动车事故各占约18万例死亡。结合有关这些死因的主要风险因素的流行病学证据来看,这种死亡模式强烈表明,全民健康战略必须继续强调个人健康意识,将其作为实现国家健康目标的主要手段。