成人死亡率中的教育不平等：亚太地区的系统回顾和荟萃分析。
Educational inequalities in adult mortality: a systematic review and meta-analysis of the Asia Pacific region.
机构信息
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
Centre for Global Health Inequalities Research, Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway.
出版信息
BMJ Open. 2022 Aug 8;12(8):e059042. doi: 10.1136/bmjopen-2021-059042.
OBJECTIVES
In this study, we aim to analyse the relationship between educational attainment and all-cause mortality of adults in the high-income Asia Pacific region.
DESIGN
This study is a comprehensive systematic review and meta-analysis with no language restrictions on searches. Included articles were assessed for study quality and risk of bias using the Joanna Briggs Institute critical appraisal checklists. A random-effects meta-analysis was conducted to evaluate the overall effect of individual level educational attainment on all-cause mortality.
SETTING
The high-income Asia Pacific Region consisting of Japan, South Korea, Singapore and Brunei Darussalam.
PARTICIPANTS
Articles reporting adult all-cause mortality by individual-level education were obtained through searches conducted from 25 November 2019 to 6 December 2019 of the following databases: PubMed, Web of Science, Scopus, EMBASE, Global Health (CAB), EconLit and Sociology Source Ultimate.
PRIMARY AND SECONDARY OUTCOME MEASURES
Adult all-cause mortality was the primary outcome of interest.
RESULTS
Literature searches resulted in 15 345 sources screened for inclusion. A total of 30 articles meeting inclusion criteria with data from the region were included for this review. Individual-level data from 7 studies covering 222 241 individuals were included in the meta-analyses. Results from the meta-analyses showed an overall risk ratio of 2.40 (95% CI 1.74 to 3.31) for primary education and an estimate of 1.29 (95% CI 1.08 to 1.54) for secondary education compared with tertiary education.
CONCLUSION
The results indicate that lower educational attainment is associated with an increase in the risk of all-cause mortality for adults in the high-income Asia Pacific region. This study offers empirical support for the development of policies to reduce health disparities across the educational gradient and universal access to all levels of education.
PROSPERO REGISTRATION NUMBER
CRD42020183923.
目的
本研究旨在分析高收入亚太地区成年人受教育程度与全因死亡率之间的关系。
设计
本研究为全面系统评价和荟萃分析，对检索无语言限制。采用 Joanna Briggs 研究所批判性评价清单评估纳入文章的研究质量和偏倚风险。采用随机效应荟萃分析评估个体受教育程度对全因死亡率的总体影响。
设置
高收入亚太地区包括日本、韩国、新加坡和文莱达鲁萨兰国。
参与者
通过 2019 年 11 月 25 日至 12 月 6 日对以下数据库的检索，获取报告成人全因死亡率与个体教育水平的文章：PubMed、Web of Science、Scopus、EMBASE、全球卫生（CAB）、EconLit 和社会学资源终极版。
主要和次要结局指标
成人全因死亡率是主要观察结局。
结果
文献检索共筛选出 15345 篇纳入文章。纳入 30 篇符合纳入标准的文章，其中有来自该地区的数据。荟萃分析纳入了 7 项研究的个体水平数据，涵盖 222241 人。荟萃分析结果显示，与高等教育相比，小学教育的总体风险比为 2.40（95%CI 1.74 至 3.31），中学教育的估计值为 1.29（95%CI 1.08 至 1.54）。
结论
结果表明，在高收入亚太地区，较低的受教育程度与成年人全因死亡率增加相关。本研究为制定政策提供了经验支持，以减少教育梯度内的健康差距，并普及各级教育。
PROSPERO 注册号：CRD42020183923。
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