Aburto José Manuel, Riffe Tim, Canudas-Romo Vladimir
Center on Population Dynamics (CPop) and Department of Public Health, University of Southern Denmark, Odense, Denmark.
Max Planck Institute for Demographic Research, Rostock, Germany.
BMJ Open. 2018 Aug 1;8(7):e022350. doi: 10.1136/bmjopen-2018-022350.
To analyse average lifespan and quantify the effect of avoidable/amenable mortality on the difference between state-specific mortality and a low-mortality benchmark in Mexico during 1990-2015.
Retrospective cross-sectional demographic analysis using aggregated data.
Vital statistics from the Mexican civil registration system.
Aggregated national data (from 91.2 million people in 1995 to 119.9 in 2015) grouped in 64 populations (32 Mexican states (including Mexico City) by sex) with cause-of-death data.
Cause-specific contributions to the gap in life expectancy with a low-mortality benchmark in three age groups (0-14, 15-49 and 50-84 years).
Infants and children under the age of 15 years show improvements towards maximal survival in all states. However, adult males aged 15 to 49 years show deterioration after 2006 in almost every state due to increasing homicides, and a slow recovery thereafter. Out of 35 potential years, females and males live on average 34.57 (34.48 to 34.67) and 33.80 (33.34 to 34.27), respectively. Adults aged 50 to 84 years show an unexpected decrease in the low mortality benchmark, indicating nationwide deterioration among older adults. Females and males in this age group show an average survival of 28.59 (27.43 to 29.75) and 26.52 (25.33 to 27.73) out of 35 potential years, respectively. State gaps from the benchmark were mainly caused by ischaemic heart diseases, diabetes, cirrhosis and homicides. We find large health disparities between states, particularly for the adult population after 2005.
Mexico has succeeded in reducing mortality and between-state inequalities in children. However, adults are becoming vulnerable as they have not been able to reduce the burden of violence and conditions amenable to health services and behaviours, such as diabetes, ischaemic heart diseases and cirrhosis. These trends have led to large health disparities between Mexican states in the last 25 years.
分析1990 - 2015年墨西哥特定州死亡率与低死亡率基准之间差异的平均寿命，并量化可避免/可改善死亡率的影响。
使用汇总数据进行回顾性横断面人口分析。
墨西哥民事登记系统的生命统计数据。
汇总的全国数据（从1995年的9120万人到2015年的1.199亿人），按64个人口群体（墨西哥32个州（包括墨西哥城）按性别划分）分组，并带有死因数据。
三个年龄组（0 - 14岁、15 - 49岁和50 - 84岁）中特定病因对与低死亡率基准相比的预期寿命差距的贡献。
15岁以下的婴儿和儿童在所有州的生存状况都朝着最大生存状态改善。然而，由于凶杀案增加，2006年后几乎每个州15至49岁的成年男性生存状况恶化，此后缓慢恢复。在35个潜在寿命年中，女性和男性平均分别存活34.57（34.48至34.67）年和33.80（33.34至34.27）年。50至84岁的成年人在低死亡率基准方面出现意外下降，表明全国老年人健康状况恶化。该年龄组的女性和男性在35个潜在寿命年中平均分别存活28.59（27.43至29.75）年和26.52（25.33至27.73）年。与基准的州差距主要由缺血性心脏病、糖尿病、肝硬化和凶杀案导致。我们发现各州之间存在巨大的健康差距，尤其是2005年后的成年人口。
墨西哥在降低儿童死亡率和州际不平等方面取得了成功。然而，成年人正变得脆弱，因为他们未能减轻暴力负担以及糖尿病、缺血性心脏病和肝硬化等可通过医疗服务和行为改善的状况的负担。这些趋势在过去25年中导致了墨西哥各州之间巨大的健康差距。
