Frisco Michelle L, Van Hook Jennifer, Hummer Robert A
Penn State University, United States.
University of North Carolina, Chapel Hill, United States.
SSM Popul Health. 2019 Feb 7;7:100374. doi: 10.1016/j.ssmph.2019.100374. eCollection 2019 Apr.
Obesity and smoking are the two leading causes of preventable death and disability in the United States. Both of these health risks are socially patterned in ways that likely produce racial/ethnic/nativity disparities in total and healthy life expectancy. The current study simulates the extent to which the hypothetical elimination of smoking and obesity would change disparities in longevity and disability by analyzing data from 19,574 U.S.-born white, black, Hispanic and foreign-born Hispanic men and women in the 1999-2000 through 2009-2010 National Health and Nutrition Examination Survey and linked mortality files. Results suggest that the elimination of both obesity and smoking would significantly narrow disparities in total and healthy life expectancy between black and white adults and remaining differences are statistically non-significant. The longstanding life expectancy advantage of Hispanic immigrants over whites is reduced, but remains large. The life expectancy advantage of U.S.-born Hispanics is reduced as well, though to a smaller extent than what is observed for Hispanic immigrants. There were no significant observed healthy life expectancy differences between white and U.S.-born Hispanic adults. Overall study results suggest that the elimination of obesity and smoking would change the shape of racial/ethnic/nativity disparities in ways that would result in greater health equity.
肥胖和吸烟是美国可预防死亡和残疾的两大主要原因。这两种健康风险都存在社会模式差异，很可能导致不同种族/族裔/出生地人群在总体预期寿命和健康预期寿命方面出现差距。本研究通过分析1999 - 2000年至2009 - 2010年美国国家健康与营养检查调查中19574名美国出生的白人、黑人、西班牙裔以及外国出生的西班牙裔男性和女性的数据，以及相关联的死亡率档案，模拟了假设消除吸烟和肥胖会在多大程度上改变寿命和残疾方面的差距。结果表明，消除肥胖和吸烟将显著缩小黑人和白人成年人在总体预期寿命和健康预期寿命方面的差距，其余差异在统计学上不显著。西班牙裔移民相对于白人长期存在的预期寿命优势有所降低，但仍然很大。美国出生的西班牙裔的预期寿命优势也有所降低，不过降幅小于西班牙裔移民。在白人成年人与美国出生的西班牙裔成年人之间，未观察到显著的健康预期寿命差异。总体研究结果表明，消除肥胖和吸烟将改变种族/族裔/出生地差距的格局，从而实现更大程度的健康公平。
