Chiavegatto Filho Alexandre Dias Porto, Beltrán-Sánchez Hiram, Kawachi Ichiro
Alexandre Dias Porto Chiavegatto Filho is with the Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil, and the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA. Hiram Beltrán-Sánchez is with the Center for Population and Development Studies, Harvard School of Public Health. Ichiro Kawachi is with the Department of Social and Behavioral Sciences, Harvard School of Public Health.
Am J Public Health. 2014 Nov;104(11):2156-62. doi: 10.2105/AJPH.2013.301565. Epub 2014 Jan 16.
We calculated life expectancy at birth for Whites, Blacks, and mixed races in Brazil, and decomposed the differences by causes of death.
We used Ministry of Health death records and 2010 Census population data (190,755,799 residents and 1,136,947 deaths). We applied the Arriaga methodology to calculate decomposition of life expectancy by cause of death. We performed sensitivity analyses for underreporting of deaths, missing data, and numerator-denominator bias.
Using standard life table methods, female life expectancy was highest for mixed races (78.80 years), followed by Whites (77.54 years), then Blacks (76.32 years). Male life expectancy was highest for Whites (71.10 years) followed closely by mixed races (71.08 years), and lower for Blacks (70.11 years). Homicides contributed the most to the relative life expectancy increase for Whites, and cancer decreased the gap. After adjustment for underreporting, missing data, and numerator-denominator bias, life expectancy was higher for Whites than for Blacks and mixed races.
Despite wide socioeconomic differences between Whites and mixed races, standard life table methods showed that mixed races had higher life expectancy than Whites for women, and similar for men. With the increase of multiracial populations, measuring racial disparities in life expectancy will be a fast-growing challenge.
我们计算了巴西白人、黑人和混血人种的出生时预期寿命,并按死因分解了差异。
我们使用了卫生部的死亡记录和2010年人口普查的人口数据(190,755,799名居民和1,136,947例死亡)。我们应用阿里亚加方法按死因计算预期寿命的分解。我们对死亡漏报、数据缺失和分子分母偏差进行了敏感性分析。
使用标准生命表方法,混血人种的女性预期寿命最高(78.80岁),其次是白人(77.54岁),然后是黑人(76.32岁)。白人男性的预期寿命最高(71.10岁),紧随其后的是混血人种(71.08岁),黑人男性的预期寿命较低(70.11岁)。杀人对白人相对预期寿命的增加贡献最大,而癌症缩小了差距。在对死亡漏报、数据缺失和分子分母偏差进行调整后,白人的预期寿命高于黑人和混血人种。
尽管白人和混血人种之间存在巨大的社会经济差异,但标准生命表方法显示,混血人种女性的预期寿命高于白人,男性则相似。随着多种族人口的增加,衡量预期寿命方面的种族差异将是一个快速增长的挑战。