Tjepkema Michael, Wilkins Russell, Long Andrea
Health Analysis Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
Health Rep. 2013 Jul;24(7):14-22.
People with lower incomes tend to have less favourable health outcomes than do people with higher incomes. Because death registrations in Canada do not contain information about the income of the deceased, vital statistics cannot be used to examine mortality by income at the individual level. However, through record linkage, information on the individual or family income of people followed for mortality can be obtained. Recently, a large, population-based sample of Canadian adults was linked to almost 16 years of mortality data.
This study examines cause-specific mortality rates by income adequacy among Canadian adults. It is based on data from the 1991 to 2006 Canadian census mortality and cancer follow-up study, which followed 2.7 million people aged 25 or older at baseline, 426,979 of whom died during the 16-year period. Age-standardized mortality rates (ASMRs), rate ratios, rate differences and excess mortality were calculated by income adequacy quintile for various causes of death.
For most causes examined, ASMRs were clearly graded by income: highest among people in the in the lowest income quintile, and lowest among people in the highest income quintile. Inter-quintile rate ratios (quintile 1/quintile 5) were greater than 2.00 for HIV/AIDS, diabetes mellitus, suicide, cancer of the cervix, and causes of death closely associated with smoking and alcohol.
These individually based results provide cause-specific information by income adequacy quintile that was not previously available for Canada.
与高收入人群相比，低收入人群往往健康状况较差。由于加拿大的死亡登记不包含死者收入信息，因此生命统计数据无法用于个体层面按收入审查死亡率。然而，通过记录链接，可以获取跟踪死亡人群的个人或家庭收入信息。最近，一项基于加拿大成年人的大型人口样本与近16年的死亡率数据建立了链接。
本研究按收入充足程度审查加拿大成年人的特定病因死亡率。它基于1991年至2006年加拿大人口普查死亡率和癌症随访研究的数据，该研究在基线时跟踪了270万25岁及以上的人，其中426,979人在16年期间死亡。按收入充足程度五分位数计算了各种死因的年龄标准化死亡率（ASMR）、率比、率差和超额死亡率。
对于大多数所研究的病因，年龄标准化死亡率按收入呈明显分级：最低收入五分位数人群中最高，最高收入五分位数人群中最低。艾滋病毒/艾滋病、糖尿病、自杀、宫颈癌以及与吸烟和饮酒密切相关的死因，其五分位数间率比（第1五分位数/第5五分位数）大于2.00。
这些基于个体的结果按收入充足程度五分位数提供了加拿大此前无法获得的特定病因信息。
