Brody J A
Public Health Rep. 1984 Sep-Oct;99(5):468-75.
In 1900, approximately 25 percent of all deaths occurred in people 65 years of age and over, while today the age at death has been pushed back so that, by 1980, 30 percent of deaths occurred in those over age 80. The greatest declines in age-specific mortality for those 65 and over occurred from 1920 to 1945 and since 1970. Illness and disability rise with age, and there is some evidence that rates of disability in all age groups may be increasing. Measurement of morbidity and disability is the area where data are weakest and our needs for data are perhaps greatest. Agreement is needed on the use, limitations, and interpretations of surveys and of data relating to functional status. In a few years, medical students and physicians will be computer literate. We should plan now for a better utilization of the already available Federal data sets as well as implementation of computerized health care information on individual patients. Some modifications of privacy legislation will probably be necessary in order for physicians to give better care to their patients, and to provide epidemiologic research opportunities in critical areas of public health needs. Caution is urged in order to maintain credibility in health promotion by avoiding overstatement of knowledge in areas where scientific evidence is weak or lacking. Better utilization and development of epidemiologic and statistical information as well as basic research in chronic diseases are urged to prepare for the year 2025, when there will be some 60 million Americans age 65 and over--about 20 percent of the total population.
1900年,所有死亡人数中约25%发生在65岁及以上的人群中,而如今死亡年龄已经后移,到1980年,30%的死亡发生在80岁以上的人群中。65岁及以上人群按年龄划分的死亡率下降幅度最大的时期是1920年至1945年以及1970年以后。疾病和残疾率随年龄增长而上升,并且有证据表明所有年龄组的残疾率可能都在增加。发病率和残疾率的衡量是数据最薄弱的领域,而我们对数据的需求可能最大。需要就调查以及与功能状态相关的数据的使用、局限性和解释达成一致。再过几年,医学生和医生将具备计算机知识。我们现在应该计划更好地利用现有的联邦数据集,并实施针对个体患者的计算机化医疗保健信息。为了让医生能更好地照顾患者,并在公共卫生需求的关键领域提供流行病学研究机会,可能需要对隐私立法进行一些修改。为了在健康促进方面保持可信度,在科学证据薄弱或缺乏的领域避免夸大知识,因此要谨慎行事。敦促更好地利用和开发流行病学和统计信息以及对慢性病进行基础研究,为2025年做好准备,届时将有大约6000万65岁及以上的美国人——约占总人口的20%。