Mehta Neil, Elo Irma, Stenholm Sari, Aromaa Arpo, Heliövaara Markku, Koskinen Seppo
University of Michigan, Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA.
University of Pennsylvania, Population Studies Center, Philadelphia, PA, USA.
SSM Popul Health. 2017 Dec;3:141-152. doi: 10.1016/j.ssmph.2016.12.001.
Despite much interest in the health risks associated with behavioral factors, little is known about whether individuals residing in different countries experience a different set of risks. International comparisons of the death risks from major behavioral factors can shed light on whether features of health systems and epidemiological histories modify the health effects of risky behaviors. We used nationally representative samples and mortality linkages spanning the 1971-2014 period from the United States and Finland to examine cross-national differences in the risks of death from cigarette smoking and obesity. We evaluated both current and former smoking and current and prior obesity. In 1990, the approximate midpoint of our study, the death risks from current smoking were about 55% higher in U.S. women compared to Finnish women, but similar for men in the two countries. Death risks from smoking significantly increased over the period for women in both countries and there was no parallel increase in risks among men. Death risks from obesity did not significantly differ in the two countries and no significant trend in the risks were detected in either country. Reasons for the relatively high and increasing risks from smoking among American women warrant further evaluation.
尽管人们对行为因素相关的健康风险十分关注，但对于居住在不同国家的个体是否面临不同的风险组合却知之甚少。对主要行为因素导致的死亡风险进行国际比较，有助于了解卫生系统的特征和流行病学历史是否会改变危险行为对健康的影响。我们使用了来自美国和芬兰的具有全国代表性的样本以及1971年至2014年期间的死亡率关联数据，来研究吸烟和肥胖导致的死亡风险的跨国差异。我们评估了当前吸烟和既往吸烟情况，以及当前肥胖和既往肥胖情况。在我们研究的大致中点年份1990年，美国女性因当前吸烟导致的死亡风险比芬兰女性高出约55%，但两国男性的这一风险相似。在这一时期，两国女性因吸烟导致的死亡风险均显著增加，而男性的风险则没有相应增加。肥胖导致的死亡风险在两国之间没有显著差异，且在任何一个国家都未发现风险有显著趋势。美国女性吸烟风险相对较高且不断增加的原因值得进一步评估。
