From the Department of Surgery, Zuckerberg San Francisco General Hospital (Boeck, Robles, Nwabuo, Plevin, Juillard, Dicker), University of California, San Francisco, CA.
the Department of Biostatistics, University of California Berkeley, Berkeley, CA (Wei, Hubbard).
J Am Coll Surg. 2022 Jan 1;234(1):32-46. doi: 10.1016/j.jamcollsurg.2021.09.008.
On average, a person living in San Francisco can expect to live 83 years. This number conceals significant variation by sex, race, and place of residence. We examined deaths and area-based social factors by San Francisco neighborhood, hypothesizing that socially disadvantaged neighborhoods shoulder a disproportionate mortality burden across generations, especially deaths attributable to violence and chronic disease. These data will inform targeted interventions and guide further research into effective solutions for San Francisco's marginalized communities.
The San Francisco Department of Public Health provided data for the 2010-2014 top 20 causes of premature death by San Francisco neighborhood. Population-level demographic data were obtained from the US American Community Survey 2015 5-year estimate (2011-2015). The primary outcome was the association between years of life loss (YLL) and adjusted years of life lost (AYLL) for the top 20 causes of death in San Francisco and select social factors by neighborhood via linear regression analysis and heatmaps.
The top 20 causes accounted for N = 15,687 San Francisco resident deaths from 2010-2014. Eight neighborhoods (21.0%) accounted for 47.9% of city-wide YLLs, with 6 falling below the city-wide median household income and many having a higher percent population Black, and lower education and higher unemployment levels. For chronic diseases and homicides, AYLLs increased as a neighborhood's percent Black, below poverty level, unemployment, and below high school education increased.
Our study highlights the mortality inequity burdening socially disadvantaged San Francisco neighborhoods, which align with areas subjected to historical discriminatory policies like redlining. These data emphasize the need to address past injustices and move toward equal access to wealth and health for all San Franciscans.
平均而言，旧金山居民的预期寿命为 83 岁。这个数字掩盖了因性别、种族和居住地点不同而存在的巨大差异。我们通过旧金山社区研究死亡人数和基于区域的社会因素，假设社会弱势群体在几代人中承担着不成比例的死亡负担，尤其是与暴力和慢性疾病相关的死亡。这些数据将为有针对性的干预措施提供信息，并指导进一步研究解决旧金山边缘化社区的有效方法。
旧金山公共卫生部提供了 2010-2014 年按旧金山社区划分的前 20 大早逝原因的数据。人口水平的人口统计数据来自美国社区调查 2015 年 5 年估计数（2011-2015 年）。主要结果是通过线性回归分析和热图，按社区比较前 20 大死因和选定社会因素的生命损失年数（YLL）和调整生命损失年数（AYLL）之间的关联。
前 20 大死因在 2010-2014 年导致旧金山居民死亡人数为 15687 人。8 个社区（21.0%）占全市 YLL 的 47.9%，其中 6 个社区的家庭中位数收入低于全市水平，许多社区的黑人比例较高，教育程度较低，失业率较高。对于慢性疾病和凶杀案，随着社区黑人比例、贫困线以下、失业率和高中以下教育水平的增加，AYLL 也随之增加。
我们的研究强调了社会弱势群体旧金山社区的不平等负担，这与历史上遭受歧视性政策如红线政策的地区一致。这些数据强调需要解决过去的不公正问题，努力为所有旧金山人提供平等获得财富和健康的机会。
