Perera Camila, Cabrera Fabián, Albizu-Campos Juan Carlos, Brønnum-Hansen Henrik
1Centre for Global Health, Trinity College Dublin, Dublin, Ireland.
2Center of Demographic Studies, University of Havana, Havana, Cuba.
Eur J Ageing. 2018 May 15;16(1):17-24. doi: 10.1007/s10433-018-0472-5. eCollection 2019 Mar.
This study explored the role of skin color in health expectancies by computing average lifetime in self-rated good health and lifetime without functional limitations in activities of daily living (ADL) among non-white and white 60+ adults living in Havana (Cuba) in 2000-2004. The Sullivan method was used to estimate health expectancies. The contributions from the mortality and health effect to the differences in health expectancies were assessed by decomposition. White males aged 60 were expected to live longer in self-rated good health than non-white males, white and non-white females. Most of the differences among males are attributed to the health effect. No differences were found between white and non-white females in expected lifetime in moderate to full ADL functioning while a difference in ADL functioning of 0.8 years favored white over non-white males. The mortality effect accounted for most difference across the two male groups. From age 80, both non-white groups could expect to live longer than their white counterparts. The results showed that skin color is a risk marker of mortality and morbidity among older adults living in Havana. Although health behaviors vary, the differences were not anticipated due to high social equity and equal health care provision in Cuba. This finding calls for further research on health expectancies by skin color that is representative of the Cuban population and includes information on different diseases and conditions.
本研究通过计算2000 - 2004年居住在哈瓦那(古巴)的60岁及以上非白人和白人成年人自我评定为健康良好的平均寿命以及日常生活活动(ADL)无功能限制的寿命,探讨了肤色在健康预期中的作用。采用沙利文方法估计健康预期。通过分解评估死亡率和健康效应对健康预期差异的贡献。60岁的白人男性预期在自我评定为健康良好的状态下比非白人男性、白人女性和非白人女性活得更长。男性之间的大多数差异归因于健康效应。在中度至完全ADL功能的预期寿命方面,白人女性和非白人女性之间未发现差异,而在ADL功能方面,白人男性比非白人男性长0.8年。死亡率效应在两个男性群体的差异中占主导。从80岁起,两个非白人组预期比白人组活得更长。结果表明,肤色是居住在哈瓦那的老年人死亡率和发病率的一个风险指标。尽管健康行为存在差异,但由于古巴社会公平性高且医疗保健提供平等,这些差异并未预料到。这一发现呼吁对代表古巴人口的肤色健康预期进行进一步研究,包括不同疾病和状况的信息。