, Washington, USA.
Utah State University, 0730 Old Main Hill, Logan, UT, 84322, USA.
BMC Public Health. 2023 Apr 26;23(1):769. doi: 10.1186/s12889-023-15668-x.
The East North Central Census division (aka the Great Lakes region) experienced a decrease in life expectancy of 0.3 years from 2014 to 2016 - one of the largest declines across the nine Census divisions. Disadvantaged groups that typically have below-average life expectancy, including Black individuals and those without a college education, may have been disproportionately affected by this longevity shift. This investigation examines life expectancy changes among different sex, race, and education groups in the Great Lakes region, and how specific causes of death contributed to within-group longevity changes over time and across age.
We used 2008 to 2017 death counts from the National Center for Health Statistics and American Community Survey population estimates to measure within-group change in life expectancy at age 25 among non-Hispanic Black and white males and females by educational attainment. We decomposed life expectancy change over time for each subgroup by 24 causes of death and measured their contribution to longevity change across 13 age groups.
Among persons with ≤ 12 years of education, white males and females experienced 1.3- and 1.7-year longevity declines respectively, compared to a 0.6-year decline among Black males and a 0.3-year decline among Black females. Life expectancy declined among all groups with 13-15 years of education, but especially Black females, who experienced a 2.2-year loss. With the exception of Black males, all groups with 16 + years of education experienced longevity gains. Homicide contributed 0.34 years to longevity decline among Black males with ≤ 12 years of education. Drug poisoning made large contributions to longevity losses among Black females with ≤ 12 years of education (0.31 years), white males and females with 13-15 years of education (0.35 and 0.21 years, respectively), and white males and females with ≤ 12 years of education (0.92 and 0.65 years, respectively).
Public health efforts to reduce the risks of homicide among Black males without a college education and drug poisoning among all groups could improve life expectancy and reduce racial and educational longevity disparities in the Great Lakes region.
从 2014 年到 2016 年，北美中东部地区（又称五大湖区）的预期寿命下降了 0.3 年——在 9 个普查区中降幅最大。通常预期寿命低于平均水平的弱势群体，包括黑人和没有大学学历的人，可能受到这种寿命变化的不成比例影响。本研究考察了五大湖区不同性别、种族和教育群体的预期寿命变化，以及特定死因如何导致特定群体随时间推移和年龄变化的寿命变化。
我们使用了 2008 年至 2017 年美国国家卫生统计中心和美国社区调查人口估计数的死亡人数，根据教育程度衡量非西班牙裔黑人和白人男性和女性在 25 岁时的预期寿命在群体内的变化。我们对每个亚组随时间的预期寿命变化进行了 24 个死因的分解，并衡量了它们在 13 个年龄组中的对寿命变化的贡献。
在受教育程度≤12 年的人群中，白人男性和女性的预期寿命分别下降了 1.3 年和 1.7 年，而黑人男性下降了 0.6 年，黑人女性下降了 0.3 年。所有受教育程度为 13-15 年的群体的预期寿命都有所下降，但受教育程度为 13-15 年的黑人女性下降幅度最大，下降了 2.2 年。除了黑人男性，所有受教育程度为 16 年及以上的群体的预期寿命都有所增加。在受教育程度≤12 年的黑人男性中，凶杀导致预期寿命减少了 0.34 年。药物中毒对受教育程度≤12 年的黑人女性（0.31 年）、受教育程度为 13-15 年的白人男性和女性（分别为 0.35 年和 0.21 年）以及受教育程度为 16 年及以上的白人男性和女性（分别为 0.92 年和 0.65 年）的预期寿命损失都有很大的贡献。
减少非大学学历黑人男性中的凶杀风险和所有群体中的药物中毒风险的公共卫生努力可以提高预期寿命，并减少五大湖区的种族和教育差异。
