自 1990 年以来，美国在生命损失年限方面的种族差异有所改善。

Improvement in racial disparities in years of life lost in the USA since 1990.

机构信息

Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America.

Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America.

出版信息

PLoS One. 2018 Apr 25;13(4):e0194308. doi: 10.1371/journal.pone.0194308. eCollection 2018.

DOI:10.1371/journal.pone.0194308

PMID:29694402

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5918944/

Abstract

OBJECTIVE

To examine changes in cause-specific Years of Life Lost (YLL) by age, race, and sex group in the USA from 1990 to 2014.

METHODS

60 million death reports from the National Center for Health Statistics (NCHS) were categorized by age group, sex, race, and cause of death. YLL were calculated using age-specific life expectancies. Age groups were: infants <1, children 1-19, adults 20-64, and older adults 65+.

RESULTS

Blacks have historically experienced more years of life lost than whites or other racial groups in the USA. In the year 1990 the YLL per 100,000 population was 21,103 for blacks, 14,160 for whites, and 7,417 for others. Between 1990 and 2014 overall YLL in the USA improved by 10%, but with marked variations in the rate of change across age, race, and sex groups. Blacks (all ages, both sexes) showed substantial improvement with a 28% reduction in YLL, compared to whites (all ages, both sexes) who showed a 4% reduction. Among blacks, improvements were seen in all age groups: reductions of 43%, 48%, 28%, and 25% among infants, children, adults, and older adults, respectively. Among whites, reductions of 33%, 44%, and 18% were seen in infants, children, and older adults, but there was a 6% increase in YLL among white adults. YLL increased by 18% in white adult females and declined 1% in white adult males. American Indian/Alaska Native women also had worsening in YLL, with an 8% increase. Asian Pacific Islanders consistently had the lowest YLL across all ages. Whites had a higher proportion of YLL due to overdose; blacks had a higher proportion due to homicide at younger ages and to heart disease at older ages.

CONCLUSIONS

Race-based disparities in YLL in the USA since 1990 have narrowed considerably, largely as a result of improvements among blacks compared to whites. Adult white and American Indian / Alaskan Native females have experienced worsening YLL, while white males have experienced essentially no change. If recent trajectories continue, adult black/white disparities in YLL will continue to narrow.

摘要

目的

分析 1990 年至 2014 年美国按年龄、种族和性别划分的特定死因寿命损失年（Years of Life Lost，YLL）变化情况。

方法

国家卫生统计中心（National Center for Health Statistics，NCHS）的 6000 万份死亡报告按年龄组、性别、种族和死因进行了分类。使用特定年龄的预期寿命计算 YLL。年龄组分为：婴儿（<1 岁）、儿童（1-19 岁）、成年人（20-64 岁）和老年人（65+岁）。

结果

在美国，黑人的寿命损失年一直高于白人或其他种族群体。1990 年，每 10 万人的 YLL 分别为黑人 21103 人、白人 14160 人、其他种族 7417 人。1990 年至 2014 年期间，美国的总体 YLL 提高了 10%，但不同年龄、种族和性别群体的变化率存在显著差异。黑人（所有年龄、所有性别）的 YLL 显著下降了 28%，而白人（所有年龄、所有性别）的 YLL 仅下降了 4%。在黑人中，所有年龄组的 YLL 均有所改善：婴儿、儿童、成年人和老年人的 YLL 分别下降了 43%、48%、28%和 25%。在白人中，婴儿、儿童和老年人的 YLL 分别下降了 33%、44%和 18%，但成年人的 YLL 增加了 6%。白人成年女性的 YLL 增加了 18%，男性则下降了 1%。美国印第安人/阿拉斯加原住民女性的 YLL 也有所恶化，增加了 8%。亚洲太平洋岛民在所有年龄段的 YLL 都最低。白人因过量用药导致 YLL 的比例更高，而黑人则因年轻时的凶杀案和老年时的心脏病导致 YLL 的比例更高。