Pan American Health Organization, Washington, DC 20037, USA.
Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA.
Int J Environ Res Public Health. 2023 Mar 24;20(7):5256. doi: 10.3390/ijerph20075256.
Violent deaths (i.e., those due to road traffic injury, homicide, and suicide) are among the most important causes of premature and preventable mortality in young people. This study aimed at exploring inequalities in violent death across income levels between males and females aged 10 to 24 years from the Americas in 2015, the SDG baseline year.
In a cross-sectional ecological study design, eleven standard summary measures of health inequality were calculated separately for males and females and for each cause of violent death, using age-adjusted mortality rates and average income per capita for 17 countries, which accounted for 87.9% of the target population.
Premature mortality due to road traffic injury and homicide showed a pro-poor inequality pattern, whereas premature mortality due to suicide showed a pro-rich inequality pattern. These inequalities were statistically significant ( < 0.001), particularly concentrated among young males, and dominated by homicide. The ample array of summary measures of health inequality tended to generate convergent results.
Significant inequalities in violent death among young people seems to be in place across countries of the Americas, and they seem to be socially determined by both income and gender. These findings shed light on the epidemiology of violent death in young people and can inform priorities for regional public health action. However, further investigation is needed to confirm inequality patterns and to explore underlying mechanisms, age- and sex-specific vulnerabilities, and gender-based drivers of such inequalities.
暴力死亡（即道路交通伤害、凶杀和自杀导致的死亡）是年轻人中最重要的过早和可预防死亡原因之一。本研究旨在探讨 2015 年（可持续发展目标基准年）美洲地区 10 至 24 岁男性和女性因暴力死亡的收入水平不平等现象。
在一项横断面生态研究设计中，使用 17 个国家的年龄调整死亡率和人均平均收入，分别为男性和女性以及每种暴力死亡原因计算了 11 种健康不平等标准综合衡量指标。这 17 个国家占目标人口的 87.9%。
道路交通伤害和凶杀导致的过早死亡呈现出有利于贫困人群的不平等模式，而自杀导致的过早死亡呈现出有利于富裕人群的不平等模式。这些不平等现象具有统计学意义（<0.001），主要集中在年轻男性中，且主要由凶杀引起。大量的健康不平等综合衡量指标往往会产生趋同的结果。
美洲国家的年轻人中似乎存在暴力死亡的显著不平等现象，这些不平等现象似乎是由收入和性别共同决定的社会因素造成的。这些发现揭示了年轻人暴力死亡的流行病学特征，并为区域公共卫生行动提供了优先事项。然而，需要进一步调查以确认不平等模式，并探讨潜在机制、年龄和性别特定的脆弱性以及此类不平等现象的性别驱动因素。
