Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 North Figueroa Street, Suite 127, Los Angeles, CA, 90012, USA.
Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 1441 Eastlake Avenue, NOR 4417, Los Angeles, CA, 90089, USA.
J Racial Ethn Health Disparities. 2016 Sep;3(3):431-43. doi: 10.1007/s40615-015-0156-1. Epub 2015 Oct 1.
Despite overall gains in life expectancy at birth among Los Angeles County residents, significant disparities persist across population subgroups. The purpose of this study was to quantify the potential sex- and race/ethnicity-specific gains in life expectancy had we been able to fully or partially eliminate the leading causes of death in Los Angeles County. Complete annual life tables for local residents were generated by applying the same method used for the National Center of Health Statistics US life tables published in 1999. Based on 2010 Los Angeles County mortality records, sex- and race/ethnicity-specific potential gains in life expectancy were calculated using scenarios of 10, 20, 50, and 100 % elimination of 12 major causes of death. Coronary heart disease, the leading cause of death, was found to be most impactful on life expectancy. Its hypothetical full elimination would result in life expectancy gains ranging from 2.2 years among white females to 3.7 years among black males. Gains from complete elimination of lung cancer and stroke ranked second, with almost an additional year of life for each gender. However, marked disparities across racial/ethnic groups were noted from the elimination of several other causes of death, such as homicide, from which the gain among black males exceeded 13 times more than their white counterparts. By differentially targeting specific causes of death in disease prevention, not only can findings of this study aid in efficiently narrowing racial/ethnic disparities, they can also provide a quantitative means to identify and rank priorities in local health policymaking.
尽管洛杉矶县居民的出生预期寿命总体有所提高，但人口亚组之间仍存在显著差异。本研究的目的是量化如果我们能够完全或部分消除洛杉矶县的主要死因，预期寿命可能会有哪些性别和种族/民族特异性的增长。通过应用与国家卫生统计中心 1999 年公布的美国生命表相同的方法，为当地居民生成完整的年度生命表。基于 2010 年洛杉矶县的死亡率记录，使用消除 12 种主要死因的 10%、20%、50%和 100%的方案，计算了性别和种族/民族特定的潜在预期寿命增长。作为主要死因的冠心病对预期寿命的影响最大。假设其完全消除，预期寿命将增加 2.2 年，白人女性增加 3.7 年，黑人男性增加 3.7 年。完全消除肺癌和中风带来的收益排名第二，每个性别都增加了将近一年的寿命。然而，从消除其他几种死因（如黑人男性的凶杀案）中可以看出，种族/民族之间存在明显的差异，他们的收益是白人的 13 倍以上。通过在疾病预防中针对特定死因采取差异化的措施，本研究的发现不仅可以帮助有效地缩小种族/民族差异，还可以为地方卫生决策提供一种定量的方法来确定和优先考虑优先事项。
