Kegler Scott R, Baldwin Grant T, Rudd Rose A, Ballesteros Michael F
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Analysis, Research, and Practice Integration, 4770 Buford Highway, Atlanta, GA, 30341, USA.
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA.
Popul Health Metr. 2017 Aug 30;15(1):32. doi: 10.1186/s12963-017-0150-4.
During the previous century the average lifespan in the United States (US) increased by over 30 years, with much of this increase attributed to public health initiatives. This report examines further gains that might be achieved through reduced occurrence of injury-related death.
US life tables and injury death rate data were used to estimate potential increases in life expectancy assuming various reductions in the rate of fatal injuries. Corresponding numbers of deaths potentially averted annually were also estimated; unit (per death) medical and lifetime work loss costs were employed to estimate total costs potentially averted annually.
Through elimination of injury as a cause of death, average US life expectancy at birth could be increased by approximately 1.5 years, with notable variations by sex, ethnicity, and race. More conservatively, average life expectancy at birth could be increased by 0.41 years assuming that the national injury death rate could be brought into line with the lowest state-specific rate. Under this more conservative but plausible assumption, an estimated 48,400 injury deaths and $61 billion in medical and work loss costs would be averted annually.
Increases in life expectancy of the magnitude considered in this report are arguably attainable based on long-term historical reductions in the US injury death rate, as well as significant continuing reductions seen in other developed countries. Contemporary evidence-based interventions can play an important role in reducing injury-related deaths, such as those due to drug overdoses and older adult falls, as well as suicides.
在上个世纪,美国的平均寿命延长了30多年,其中很大一部分增长归因于公共卫生举措。本报告探讨了通过减少与伤害相关的死亡发生率可能实现的进一步增长。
使用美国生命表和伤害死亡率数据来估计假设致命伤害率有各种降低情况下预期寿命的潜在增加。还估计了每年可能避免的相应死亡人数;采用单位(每例死亡)医疗和终身工作损失成本来估计每年可能避免的总成本。
通过消除伤害作为死因,美国出生时的平均预期寿命可增加约1.5岁,不同性别、族裔和种族存在显著差异。更保守地说,假设全国伤害死亡率能与最低的州特定率保持一致,出生时的平均预期寿命可增加0.41岁。在这个更保守但合理的假设下,估计每年可避免48,400例伤害死亡以及610亿美元的医疗和工作损失成本。
基于美国伤害死亡率的长期历史下降以及其他发达国家持续显著的下降情况,本报告中所考虑的预期寿命增长幅度可以说是可以实现的。当代基于证据的干预措施在减少与伤害相关的死亡方面可以发挥重要作用,例如因药物过量、老年人跌倒以及自杀导致的死亡。