Reynolds Robert J, Day Steven M, Shafer Alan, Becker Emilie
1 Mortality Research & Consulting, Inc., City of Industry, CA.
2 Texas Department of State Health Services, Austin, TX.
J Insur Med. 2018;47(4):212-219. doi: 10.17849/insm-47-04-1-8.1. Epub 2019 Jan 17.
-To compute mortality rates and excess death rates for patients with serious mental illness, specific to categories of gender, age and race/ethnicity.
-People with serious mental illness are known to be at greatly increased risk of mortality across the lifespan. However, the measures of mortality reported for this high-risk population are typically only summary measures, which do not provide either the mortality rates or excess death rates needed to construct life tables for individuals with serious mental illness.
-Mortality rates were computed by dividing the number of deaths by the amount of life-years lived in strata specific to gender, age and race/ethnicity. Age-specific excess death rates were determined as the difference between the study population rate and the corresponding general population rate in each stratum. To compute excess death rates beyond observed ages in the cohort, a method with documented reliability and validity for chronic medical conditions was used.
-For the cohort with mental illness, mortality rates for Black and White females were mostly equal, and consistently greater than those for Hispanic females; excess death rates for females displayed a similar pattern. Among males, mortality rates were highest for Whites, with Hispanics and Blacks close in magnitude at all ages. Excess death rates for males showed more divergence between the categories of race/ethnicity across the age range.
-Mortality rates specific to categories of gender, age and race/ethnicity show sufficient differences as to make them the preferred way to construct life tables. This is especially true in contrast to broader summary measures such as risk ratios, standardized incidence rates, or life expectancy.
计算严重精神疾病患者的死亡率和超额死亡率，按性别、年龄和种族/族裔类别进行细分。
已知严重精神疾病患者在其整个生命周期内死亡风险大幅增加。然而，针对这一高危人群报告的死亡率指标通常只是汇总指标，无法提供构建严重精神疾病患者生命表所需的死亡率或超额死亡率。
通过将死亡人数除以按性别、年龄和种族/族裔划分的各层生存年数来计算死亡率。特定年龄的超额死亡率被确定为各层研究人群率与相应一般人群率之间的差值。为计算队列中观察年龄以上的超额死亡率，采用了一种在慢性疾病方面具有可靠记录的可靠性和有效性的方法。
对于患有精神疾病的队列，黑人和白人女性的死亡率大多相等，且始终高于西班牙裔女性；女性的超额死亡率呈现类似模式。在男性中，白人的死亡率最高，西班牙裔和黑人在各年龄段的死亡率相近。男性的超额死亡率在不同种族/族裔类别之间在整个年龄范围内表现出更大差异。
按性别、年龄和种族/族裔类别划分的死亡率显示出足够的差异，使其成为构建生命表的首选方式。与风险比、标准化发病率或预期寿命等更宽泛的汇总指标相比，尤其如此。
