Cunningham Timothy J, Croft Janet B, Liu Yong, Lu Hua, Eke Paul I, Giles Wayne H
MMWR Morb Mortal Wkly Rep. 2017 May 5;66(17):444-456. doi: 10.15585/mmwr.mm6617e1.
Although the overall life expectancy at birth has increased for both blacks and whites and the gap between these populations has narrowed, disparities in life expectancy and the leading causes of death for blacks compared with whites in the United States remain substantial. Understanding how factors that influence these disparities vary across the life span might enhance the targeting of appropriate interventions.
Trends during 1999-2015 in mortality rates for the leading causes of death were examined by black and white race and age group. Multiple 2014 and 2015 national data sources were analyzed to compare blacks with whites in selected age groups by sociodemographic characteristics, self-reported health behaviors, health-related quality of life indicators, use of health services, and chronic conditions.
During 1999-2015, age-adjusted death rates decreased significantly in both populations, with rates declining more sharply among blacks for most leading causes of death. Thus, the disparity gap in all-cause mortality rates narrowed from 33% in 1999 to 16% in 2015. However, during 2015, blacks still had higher death rates than whites for all-cause mortality in all groups aged <65 years. Compared with whites, blacks in age groups <65 years had higher levels of some self-reported risk factors and chronic diseases and mortality from cardiovascular diseases and cancer, diseases that are most common among persons aged ≥65 years.
To continue to reduce the gap in health disparities, these findings suggest an ongoing need for universal and targeted interventions that address the leading causes of deaths among blacks (especially cardiovascular disease and cancer and their risk factors) across the life span and create equal opportunities for health.
尽管黑人和白人的出生时预期寿命总体上都有所增加,且这两个人口群体之间的差距已经缩小,但在美国,与白人相比,黑人在预期寿命和主要死因方面的差异仍然很大。了解影响这些差异的因素如何在整个生命周期中变化,可能会加强对适当干预措施的针对性。
按黑人和白人种族以及年龄组,研究了1999 - 2015年期间主要死因的死亡率趋势。分析了2014年和2015年多个国家数据源,以按社会人口学特征、自我报告的健康行为、健康相关生活质量指标、医疗服务使用情况和慢性病,比较特定年龄组中的黑人和白人。
在1999 - 2015年期间,两个群体的年龄调整死亡率均显著下降,大多数主要死因的死亡率在黑人中下降得更为明显。因此,全因死亡率的差异差距从1999年的33%缩小到2015年的16%。然而,在2015年,所有年龄小于65岁的群体中,黑人的全因死亡率仍高于白人。与白人相比,年龄小于65岁的黑人某些自我报告的风险因素和慢性病水平较高,心血管疾病和癌症的死亡率也较高,而这些疾病在65岁及以上人群中最为常见。
为了继续缩小健康差异差距,这些发现表明,持续需要采取普遍和有针对性的干预措施,以解决黑人(尤其是心血管疾病和癌症及其风险因素)在整个生命周期中的主要死因,并创造平等的健康机会。