Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (J.C., M.E.Y.).
Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois (A.P., M.L.D.).
Ann Intern Med. 2024 Mar;177(3):303-314. doi: 10.7326/M23-1990. Epub 2024 Mar 5.
All-cause mortality among diverse Hispanic/Latino groups in the United States and factors underlying mortality differences have not been examined prospectively.
To describe cumulative all-cause mortality (and factors underlying differences) by Hispanic/Latino background, before and during the COVID-19 pandemic.
Prospective, multicenter cohort study.
Hispanic Community Health Study/Study of Latinos.
15 568 adults aged 18 to 74 years at baseline (2008 to 2011) of Central American, Cuban, Dominican, Mexican, Puerto Rican, South American, and other backgrounds from the Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California.
Sociodemographic, acculturation-related, lifestyle, and clinical factors were assessed at baseline, and vital status was ascertained through December 2021 (969 deaths; 173 444 person-years of follow-up). Marginally adjusted cumulative all-cause mortality risks (11-year before the pandemic and 2-year during the pandemic) were examined using progressively adjusted Cox regression.
Before the pandemic, 11-year cumulative mortality risks adjusted for age and sex were higher in the Puerto Rican and Cuban groups (6.3% [95% CI, 5.2% to 7.6%] and 5.7% [CI, 5.0% to 6.6%], respectively) and lowest in the South American group (2.4% [CI, 1.7% to 3.5%]). Differences were attenuated with adjustment for lifestyle and clinical factors. During the pandemic, 2-year cumulative mortality risks adjusted for age and sex ranged from 1.1% (CI, 0.6% to 2.0%; South American) to 2.0% (CI, 1.4% to 3.0%; Central American); CIs overlapped across groups. With adjustment for lifestyle factors, 2-year cumulative mortality risks were highest in persons of Central American and Mexican backgrounds and lowest among those of Puerto Rican and Cuban backgrounds.
Lack of data on race and baseline citizenship status; correlation between Hispanic/Latino background and site.
Differences in prepandemic mortality risks across Hispanic/Latino groups were explained by lifestyle and clinical factors. Mortality patterns changed during the pandemic, with higher risks in persons of Central American and Mexican backgrounds than in those of Puerto Rican and Cuban backgrounds.
National Institutes of Health.
美国不同西班牙裔/拉丁裔群体的全因死亡率以及导致死亡率差异的因素尚未得到前瞻性研究。
描述西班牙裔/拉丁裔背景人群在新冠疫情前和疫情期间的全因死亡率（以及死亡率差异的潜在因素）。
前瞻性、多中心队列研究。
西班牙裔社区健康研究/拉丁裔研究。
15568 名年龄在 18 至 74 岁之间的成年人，他们来自纽约布朗克斯、伊利诺伊州芝加哥、佛罗里达州迈阿密和加利福尼亚州圣地亚哥，具有中美洲、古巴、多米尼加、墨西哥、波多黎各、南美洲和其他背景，于 2008 年至 2011 年进行了基线调查。
在基线时评估了社会人口统计学、与文化适应相关的、生活方式和临床因素，并通过 2021 年 12 月确定了生存状况（969 例死亡；173444 人年随访）。使用逐步调整的 Cox 回归分析，检查了调整年龄和性别后的全因死亡率的累积风险（疫情前 11 年和疫情期间 2 年）。
在疫情前，经年龄和性别调整的 11 年累积死亡率在波多黎各和古巴群体中较高（分别为 6.3%[95%CI，5.2%至 7.6%]和 5.7%[CI，5.0%至 6.6%]），在南美洲群体中最低（2.4%[CI，1.7%至 3.5%]）。通过调整生活方式和临床因素，差异有所减弱。在疫情期间，经年龄和性别调整的 2 年累积死亡率范围从南美洲的 1.1%（CI，0.6%至 2.0%）到中美洲的 2.0%（CI，1.4%至 3.0%）；各群体的 CI 存在重叠。在调整生活方式因素后，中美洲和墨西哥背景人群的 2 年累积死亡率最高，而波多黎各和古巴背景人群的死亡率最低。
缺乏关于种族和基线公民身份的数据；西班牙裔/拉丁裔背景与地点之间存在相关性。
西班牙裔/拉丁裔群体之间的死亡率差异可以用生活方式和临床因素来解释。在疫情期间，死亡率模式发生了变化，中美洲和墨西哥背景人群的风险高于波多黎各和古巴背景人群。
美国国立卫生研究院。
