Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain.
Pla Director de Malalties de l'Aparell Circulatori (PDMAC), Health Department of the Government of Catalonia, Catalonia, Spain; Community Heart Failure Program, Department of Cardiology, Bellvitge University Hospital and Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Prev Med. 2019 Jun;123:91-94. doi: 10.1016/j.ypmed.2019.03.005. Epub 2019 Mar 7.
We evaluated the association between individual-level socioeconomic status (SES), life expectancy, and mortality, in adult men and women from the general population living in Catalonia, a universal healthcare coverage setting. We used the Catalan Health Surveillance System database, which includes individual-level information on sociodemographic characteristics and mortality for all residents of Catalonia (Spain). We categorized individuals as high, medium, low or very low SES based on annual personal income and welfare receipt. We used 2016 mortality data to estimate life expectancy at age 18, and the probability of death by age, sex and SES categories. We followed a total of 6,027,424 Catalan residents in 2016. Men and women of very low SES had 12.0 and 9.4 years lower life expectancy compared to men and women of high SES, respectively. Low SES was also strongly associated with mortality in both men and women of any age. In the entire adult population of Catalonia, despite the availability of universal, high quality healthcare coverage, low SES is associated with lower life expectancy and higher mortality. Solutions to these large inequalities may combine tailored health promotion and management interventions, with solutions coming from outside of the health sector.
我们评估了个体社会经济地位（SES）、预期寿命和死亡率之间的关联，研究对象为居住在加泰罗尼亚（西班牙）的、具有普遍医疗保健覆盖的普通人群中的成年男女。我们使用了加泰罗尼亚健康监测系统数据库，该数据库包含加泰罗尼亚所有居民的个体社会人口统计学特征和死亡率信息。我们根据年收入和福利领取情况，将个体分为高、中、低或极低 SES 群体。我们使用 2016 年的死亡率数据来估计 18 岁时的预期寿命，以及按性别和 SES 类别划分的死亡概率。我们总共随访了 2016 年的 6027424 名加泰罗尼亚居民。与高 SES 相比，极低 SES 的男性和女性的预期寿命分别低 12.0 年和 9.4 年。在任何年龄段的男性和女性中，低 SES 也与死亡率密切相关。在加泰罗尼亚的整个成年人口中，尽管提供了普遍的、高质量的医疗保健覆盖，但低 SES 与较低的预期寿命和较高的死亡率相关。解决这些巨大不平等问题的方案可能需要结合有针对性的健康促进和管理干预措施，并且这些方案可能来自医疗保健领域之外。
