Surveillance & Health Equity Science, American Cancer Society, Atlanta, GA, USA.
Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA.
J Gen Intern Med. 2022 Sep;37(12):2923-2930. doi: 10.1007/s11606-021-07268-5. Epub 2022 Jun 22.
Eliminating health disparities among different segments of the US population is an overarching goal of the US Healthy People 2020 objectives.
Examine changes in educational, rural-urban, and racial disparities in premature mortality during the past 10 years.
Descriptive analysis of US mortality data from 2007 to 2017.
Relative and absolute rural-urban, educational attainment, and Black-White disparities in premature mortality for all-cause and top 10 causes of death among persons ages 25-74 years, estimated as rate ratios and rate differences between ≤12 and ≥16 years of education, rural versus urban, and non-Hispanic Black (Black) versus non-Hispanic White (White), respectively, in 2007 and 2017.
During 2007-2017, mortality rates in persons aged 25-74 years in the USA increased for several leading causes of death, especially in persons with <16 years of education, rural residents, and White people. As a result, disparity in mortality between 2007 and 2017 widened on both relative and absolute scales for all-cause and for 6 of the top 10 causes of death by education and for all-cause and for 9 of the top 10 causes by rural/urban residence. In contrast, Black-White disparities narrowed for all-cause and for all 7 causes that Black people had a higher rate than White people. For all-cause mortality for example, absolute disparities in the number of deaths per 100,000 person-years between 2007 and 2017 increased from 454.0 (95%CI, 446.0-462.1) to 542.7 (535.6-549.7) for educational attainment and from 85.8 (82.8-88.8) to 140.5 (137.6-143.4) for rural versus urban; in contrast, absolute Black-White disparity decreased from 315.3 (311.0-319.7) to 221.7 (218.1-225.3).
Educational and rural-urban disparities in premature mortality widened, whereas Black-White disparities narrowed in the USA between 2007 and 2017, though overall rates remained considerably higher in Black people.
消除美国不同人群之间的健康差距是美国“健康人民 2020 目标”的首要目标。
研究过去 10 年中，教育、城乡和种族在过早死亡方面的差距变化。
对 2007 年至 2017 年美国死亡数据进行描述性分析。
在 25-74 岁人群中，对所有原因和十大死因的过早死亡率进行城乡、教育程度、黑人和白人之间的相对和绝对差距评估，使用率比和率差来表示，分别为 2007 年和 2017 年接受≤12 年和≥16 年教育、城乡之间以及非西班牙裔黑人（黑人）与非西班牙裔白人（白人）之间的差异。
在 2007-2017 年期间，美国 25-74 岁人群中几种主要死因的死亡率上升，尤其是受教育程度较低、农村居民和白人。因此，2007 年至 2017 年期间，所有原因和十大死因中的六种原因、城乡之间的所有原因和十大死因中的九种原因的死亡率差距都在相对和绝对两个方面扩大。相比之下，黑人和白人之间的差距在所有原因和所有七种黑人死亡率高于白人的原因上都缩小了。例如，在所有原因的死亡率方面，2007 年至 2017 年，每 10 万人中每 100,000 人年的死亡人数绝对差距从 454.0（95%CI，446.0-462.1）增加到 542.7（535.6-549.7），从 85.8（82.8-88.8）增加到 140.5（137.6-143.4）。相比之下，绝对的黑人和白人差距从 315.3（311.0-319.7）减少到 221.7（218.1-225.3）。
2007 年至 2017 年期间，美国的教育和城乡之间的过早死亡率差距扩大，而黑人和白人之间的差距缩小，尽管黑人的总体死亡率仍然高得多。
