Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
J Racial Ethn Health Disparities. 2018 Feb;5(1):50-61. doi: 10.1007/s40615-017-0341-5. Epub 2017 Feb 24.
Black men have the lowest life expectancy of all major ethnic-sex populations in the USA, yet no recent studies have comprehensively examined black male mortality.
The purpose of this study was to analyze recent mortality trends for black men, including black to white (B to W) disparities.
The study design was national mortality surveillance for 2000 to 2014.
The setting was the USA.
All black non-Hispanic males aged ≥15 years old in the USA, including institutionalized persons, were included.
The 15 leading causes of death were analyzed.
Linear regression of log-transformed annual age-adjusted death rates was used to calculate average annual percent change (AAPC) in mortality. Black to white (B to W) disparity rate ratios (RR) and 95% confidence intervals (CI) were compared for 2000 and 2014. The most recent available social and economic profile data were obtained from the U.S. Census of Population.
The top five causes of death for black men in 2014, with percentage of total deaths, were (1) heart disease (24.8%), (2) cancer (23.0%), (3) unintentional injuries (5.8%), (4) stroke (5.1%), and (5) homicide (4.3%). Significant mortality declines for 12 of the 15 leading causes occurred through 2014, with the strongest decline for HIV/AIDS (AAPC -8.0, 95% CI -8.8 to -7.1). Only Alzheimer's disease, ranked #15, significantly increased (AAPC +2.5, 95% CI +1.4 to +3.7). Significant black disadvantage persisted for 10 of the 15 leading causes in 2014, including homicide (RR = 10.43, 95% CI 9.98 to 10.89), HIV/AIDS (RR = 8.01, 95% CI 7.50 to 8.54), diabetes (RR = 1.88, 95% CI 1.82 to 1.93), and stroke (RR = 1.61, 95% CI 1.57 to 1.65). The B to W disparity did not improve for heart disease (RR 1.24 in 2000 vs. RR 1.23 in 2014), but did improve for cancer (RR 1.39 in 2000 vs. 1.20 in 2014). Death rates were significantly lower in black men for five causes, including unintentional injuries (RR = 0.83, 95% CI 0.80 to 0.84), chronic lower respiratory diseases (RR = 0.75, 95% CI 0.73 to 0.78), and suicide (RR = 0.37, 95% CI 0.35 to 0.39).
Total mortality significantly declined for black men from 2000 to 2014, and the overall B to W disparity narrowed to RR = 1.21 (95% CI 1.20 to 1.23) in 2014. However, significant black disadvantages relative to white men persisted for 10 leading causes of death.
黑人是美国所有主要种族-性别群体中预期寿命最低的人群，但最近没有研究全面检查黑人男性的死亡率。
本研究旨在分析黑人男性最近的死亡率趋势，包括黑人和白人之间的差异。
研究设计为 2000 年至 2014 年的全国死亡率监测。
美国。
包括机构内人员在内的所有年龄在 15 岁以上的非西班牙裔黑人男性。
分析了 15 种主要死因。
使用对数转换的年度年龄调整死亡率的线性回归来计算死亡率的平均年百分比变化（AAPC）。比较了 2000 年和 2014 年的黑人和白人（B 与 W）差异率比（RR）和 95%置信区间（CI）。从美国人口普查中获得了最新的可用社会和经济概况数据。
2014 年黑人男性的前五大死因，占总死亡人数的百分比分别为：（1）心脏病（24.8%）、（2）癌症（23.0%）、（3）意外伤害（5.8%）、（4）中风（5.1%）和（5）杀人（4.3%）。到 2014 年，15 种主要死因中有 12 种的死亡率显著下降，其中艾滋病毒/艾滋病的下降幅度最大（AAPC-8.0，95%CI-8.8 至-7.1）。只有排名第 15 的阿尔茨海默病显著增加（AAPC+2.5，95%CI+1.4 至+3.7）。2014 年，15 种主要死因中有 10 种仍存在黑人明显劣势，包括杀人（RR=10.43，95%CI9.98 至 10.89）、艾滋病毒/艾滋病（RR=8.01，95%CI7.50 至 8.54）、糖尿病（RR=1.88，95%CI1.82 至 1.93）和中风（RR=1.61，95%CI1.57 至 1.65）。心脏病（2000 年 RR1.24 与 2014 年 RR1.23）的 B 与 W 差异没有改善，但癌症（2000 年 RR1.39 与 2014 年 RR1.20）的差异有所改善。黑人男性的五种死因死亡率明显较低，包括意外伤害（RR=0.83，95%CI0.80 至 0.84）、慢性下呼吸道疾病（RR=0.75，95%CI0.73 至 0.78）和自杀（RR=0.37，95%CI0.35 至 0.39）。
从 2000 年到 2014 年，黑人男性的总死亡率显著下降，黑人与白人的总体差异缩小到 2014 年的 RR=1.21（95%CI1.20 至 1.23）。然而，黑人男性在 10 种主要死因方面仍明显处于劣势。
