Verstraeten Soraya P A, van Oers Hans A M, Mackenbach Johan P
Institute for Public Health (Volksgezondheid Instituut Curaçao) Institute for Public Health (Volksgezondheid Instituut Curaçao) Ministry of Health, Environment and Nature Willemstad Curaçao Institute for Public Health (Volksgezondheid Instituut Curaçao), Ministry of Health, Environment and Nature, Willemstad, Curaçao.
Ministry of Health, Welfare and Sport Ministry of Health, Welfare and Sport The Hague the Netherlands Ministry of Health, Welfare and Sport, The Hague, the Netherlands.
Rev Panam Salud Publica. 2020 May 21;44:e38. doi: 10.26633/RPSP.2020.38. eCollection 2020.
To identify specific health care areas whose optimization could improve population health in the Dutch Caribbean islands of Aruba and Curaçao.
Comparative observational study using mortality and population data of the Dutch Caribbean islands and the Netherlands. Mortality trends were calculated, then analyzed with Joinpoint software, for the period 1988-2014. Life expectancies were computed using abridged life tables for the most recent available data of all territories (2005-2007). Life expectancy differences between the Dutch Caribbean and the Netherlands were decomposed into cause-specific contributions using Arriaga's method.
During the period 1988-2014, levels of amenable mortality have been consistently higher in Aruba and Curaçao than in the Netherlands. For Aruba, the gap in amenable mortality with the Netherlands did not significantly change during the study period, while it widened for Curaçao. If mortality from amenable causes were reduced to similar levels as in the Netherlands, men and women in Aruba would have added, respectively, 1.19 years and 0.72 years to their life expectancies during the period 2005-2007. In Curaçao, this would be 2.06 years and 2.33 years. The largest cause-specific contributions were found for circulatory diseases, breast cancer, perinatal causes, and nephritis/nephrosis (these last two causes solely in Curaçao).
Improvements in health care services related to circulatory diseases, breast cancer, perinatal deaths, and nephritis/nephrosis in the Dutch Caribbean could substantially contribute to reducing the gap in life expectancy with the Netherlands. Based on our study, we recommend more in-depth studies to identify the specific interventions and resources needed to optimize the underlying health care areas.
确定哪些特定的医疗保健领域得到优化后能够改善荷兰加勒比地区阿鲁巴岛和库拉索岛居民的健康状况。
采用比较性观察研究，运用荷兰加勒比地区岛屿和荷兰的死亡率及人口数据。计算1988年至2014年期间的死亡率趋势，然后使用Joinpoint软件进行分析。利用简略寿命表计算所有地区（2005 - 2007年）最新可得数据的预期寿命。采用阿里亚加方法将荷兰加勒比地区与荷兰之间的预期寿命差异分解为特定病因的贡献。
在1988年至2014年期间，阿鲁巴岛和库拉索岛可避免死亡率水平一直高于荷兰。对于阿鲁巴岛，研究期间其与荷兰在可避免死亡率方面的差距没有显著变化，而库拉索岛的这一差距有所扩大。如果可避免病因导致的死亡率降低到与荷兰类似的水平，在2005年至2007年期间，阿鲁巴岛的男性和女性预期寿命将分别增加1.19岁和0.72岁。在库拉索岛，这一增幅将分别为2.06岁和2.33岁。特定病因贡献最大的是循环系统疾病、乳腺癌、围产期病因以及肾炎/肾病（最后这两个病因仅存在于库拉索岛）。
荷兰加勒比地区在循环系统疾病、乳腺癌、围产期死亡以及肾炎/肾病相关医疗保健服务方面的改善，可极大地有助于缩小与荷兰在预期寿命方面的差距。基于我们的研究，我们建议开展更深入的研究，以确定优化基础医疗保健领域所需的具体干预措施和资源。
