Stephens Alexandre S, Gupta Leena, Thackway Sarah, Broome Richard A
Public Health Observatory, Sydney Local Health District, Sydney, New South Wales, Australia.
Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, New South Wales, Australia.
BMJ Open. 2017 Jan 10;7(1):e013227. doi: 10.1136/bmjopen-2016-013227.
Despite being one of the healthiest countries in the world, Australia displays substantial mortality differentials by socioeconomic disadvantage, remoteness and sex. In this study, we examined how these mortality differentials translated to differences in life expectancy between 2001 and 2012.
Population-based study using mortality and estimated residential population data from Australia's largest state, New South Wales (NSW), between 2001 and 2012. Age-group-specific death rates by socioeconomic disadvantage quintile, remoteness (major cities vs regional and remote areas), sex and year were estimated via Poisson regression, and inputted into life table calculations to estimate life expectancy.
Life expectancy decreased with increasing socioeconomic disadvantage in males and females. The disparity between the most and least socioeconomically deprived quintiles was 3.77 years in males and 2.39 years in females in 2012. Differences in life expectancy by socioeconomic disadvantage were mostly stable over time. Gender gaps in life expectancy ranged from 3.50 to 4.93 years (in 2012), increased with increasing socioeconomic disadvantage and decreased by ∼1 year for all quintiles between 2001 and 2012. Overall, life expectancy varied little by remoteness, but was 1.8 years higher in major cities compared to regional/remote areas in the most socioeconomically deprived regions in 2012.
Socioeconomic disadvantage and sex were strongly associated with life expectancy. The disparity in life expectancy across the socioeconomic spectrum was larger in males and was stable over time. In contrast, gender gaps reduced for all quintiles between 2001 and 2012, and a remoteness effect was evident in 2012, but only for those living in the most deprived areas.
尽管澳大利亚是世界上最健康的国家之一，但该国在死亡率方面存在显著差异，这些差异与社会经济劣势、居住偏远程度和性别有关。在本研究中，我们考察了在2001年至2012年期间，这些死亡率差异如何转化为预期寿命的差异。
基于澳大利亚最大的州新南威尔士州（NSW）2001年至2012年期间的死亡率和估计常住人口数据进行的基于人群的研究。通过泊松回归估计按社会经济劣势五分位数、居住偏远程度（大城市与地区及偏远地区）、性别和年份划分的特定年龄组死亡率，并将其输入寿命表计算中以估计预期寿命。
男性和女性的预期寿命均随社会经济劣势的增加而降低。2012年，社会经济最贫困五分位数组与最不贫困五分位数组之间的差距在男性中为3.77岁，在女性中为2.39岁。随着时间的推移，社会经济劣势导致的预期寿命差异大多保持稳定。预期寿命的性别差距在2012年为3.50至4.93岁，随社会经济劣势的增加而增大，在2001年至2012年期间，所有五分位数组的性别差距均减少了约1岁。总体而言，预期寿命随居住偏远程度的变化不大，但在2012年，在社会经济最贫困地区，大城市的预期寿命比地区/偏远地区高1.8岁。
社会经济劣势和性别与预期寿命密切相关。社会经济范围内预期寿命的差距在男性中更大，且随时间保持稳定。相比之下，2001年至2012年期间所有五分位数组的性别差距均有所缩小，2012年存在居住偏远程度影响，但仅针对生活在最贫困地区的人群。
