Chang Su-Hsin, Yu Yao-Chi, Carlsson Nils P, Liu Xiaoyan, Colditz Graham A
Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
Department of Electrical and Systems Engineering, School of Engineering, Washington University in St. Louis, St. Louis, Missouri.
Obesity (Silver Spring). 2017 May;25(5):950-957. doi: 10.1002/oby.21822. Epub 2017 Mar 22.
This study investigated racial disparity in life expectancies (LEs) and life years lost (LYL) associated with multiple obesity-related chronic conditions (OCCs).
Data from the Medical Expenditure Panel Survey, 2008-2012, were used. Four OCCs were studied: diabetes, hypertension, coronary heart disease (CHD), and stroke. LE for each subpopulation was simulated by Markov modelling. LYL associated with a disease for a subpopulation was computed by taking the difference between LEs for members of that subpopulation without disease and LEs for members of that subpopulation who had that disease. Racial disparities were measured in the absolute differences in LE and LYL between black women/men and white women/men.
Black individuals had higher risks of developing diabetes, hypertension, and stroke. This disparity in LE between white and black participants was largest in men age 40 to 49 with at least stroke: black men lived 3.12 years shorter than white men. The disparity in LYL between white and black participants was largest in women age 70 to 79 with at least CHD: black women had 1.98 years more LYL than white women.
Racial disparity exists in incident disease and mortality risks, LEs, and LYL associated with multiple OCCs. Efforts targeting subpopulations with large disparities are required to reduce disparities in the burden of multiple OCCs.
本研究调查了与多种肥胖相关慢性病(OCCs)相关的预期寿命(LEs)和生命年损失(LYL)方面的种族差异。
使用了2008 - 2012年医疗支出小组调查的数据。研究了四种OCCs:糖尿病、高血压、冠心病(CHD)和中风。通过马尔可夫模型模拟每个亚人群的预期寿命。某亚人群与某疾病相关的生命年损失通过计算该亚人群中无疾病成员的预期寿命与患有该疾病成员的预期寿命之差来得出。通过测量黑人女性/男性与白人女性/男性在预期寿命和生命年损失方面的绝对差异来衡量种族差异。
黑人患糖尿病、高血压和中风的风险更高。在40至49岁至少患中风的男性中,白人和黑人参与者之间的预期寿命差异最大:黑人男性比白人男性少活3.12年。在70至79岁至少患冠心病的女性中,白人和黑人参与者之间的生命年损失差异最大:黑人女性比白人女性多损失1.98年的生命年。
在与多种OCCs相关的发病疾病、死亡风险、预期寿命和生命年损失方面存在种族差异。需要针对差异较大的亚人群采取措施,以减少多种OCCs负担方面的差异。