Auger Nathalie, Feuillet Pascaline, Martel Sylvie, Lo Ernest, Barry Amadou D, Harper Sam
Analyse de la santé et des inégalités sociales et territoriales, Institut national de santé publique du Québec, Montréal, Canada; Axe Risques à la santé, Research Centre of the University of Montreal Hospital Centre, Montreal, Canada.
Institut de Démographie de l'Université Paris 1, Université Panthéon-Sorbonne, Paris, France.
Ann Epidemiol. 2014 Aug;24(8):575-80, 580.e1. doi: 10.1016/j.annepidem.2014.05.006. Epub 2014 May 27.
Life expectancy is used to measure population health, but large differences in mortality can be masked even when there is no life expectancy gap. We demonstrate how Arriaga's decomposition method can be used to assess inequality in mortality between populations with near equal life expectancy.
We calculated life expectancy at birth for Quebec and the rest of Canada from 2005 to 2009 using life tables and partitioned the gap between both populations into age and cause-specific components using Arriaga's method.
The life expectancy gap between Quebec and Canada was negligible (<0.1 years). Decomposition of the gap showed that higher lung cancer mortality in Quebec was offset by cardiovascular mortality in the rest of Canada, resulting in identical life expectancy in both groups. Lung cancer in Quebec had a greater impact at early ages, whereas cardiovascular mortality in Canada had a greater impact at older ages.
Despite the absence of a gap, we demonstrate using decomposition analyses how lung cancer at early ages lowered life expectancy in Quebec, whereas cardiovascular causes at older ages lowered life expectancy in Canada. We provide SAS/Stata code and an Excel spreadsheeet to facilitate application of Arriaga's method to other settings.
预期寿命用于衡量人群健康状况，但即便不存在预期寿命差距，死亡率的巨大差异也可能被掩盖。我们展示了如何使用阿里亚加分解法来评估预期寿命相近的人群之间的死亡率不平等情况。
我们利用生命表计算了2005年至2009年魁北克省和加拿大其他地区的出生时预期寿命，并使用阿里亚加方法将这两个人群之间的差距划分为年龄和特定病因组成部分。
魁北克省和加拿大之间的预期寿命差距微不足道（<0.1岁）。差距分解表明，魁北克省较高的肺癌死亡率被加拿大其他地区的心血管疾病死亡率所抵消，导致两组的预期寿命相同。魁北克省的肺癌在早年产生的影响更大，而加拿大的心血管疾病死亡率在老年时产生的影响更大。
尽管没有差距，但我们通过分解分析表明，早年的肺癌如何降低了魁北克省的预期寿命，而老年时的心血管疾病病因如何降低了加拿大的预期寿命。我们提供了SAS/Stata代码和一个Excel电子表格，以方便将阿里亚加方法应用于其他情况。
