Wingard D L
Am J Epidemiol. 1982 Feb;115(2):205-16. doi: 10.1093/oxfordjournals.aje.a113292.
By using the 1965 Human Population Laboratory Survey of a random sample of 6928 adults in Alameda County, California, and a nine-year follow-up, mortality risk is examined by sex, while simultaneously controlling for 16 demographic and behavioral risk factors by a multiple logistic analysis. Risk factors include age, race, socioeconomic status, occupation, physical health status, use of health services, smoking, alcohol consumption, physical activity, weight, sleeping patterns, marital status, social contacts, church and group membership and life satisfaction. The prevalence and relative mortality risk of each factor combine to influence the sex differential. The unadjusted relative mortality risk for men compared to women is 1.5 (p less than or equal to 0.001). Adjustment for some factors (e.g., smoking and alcohol) decreases this difference, while other adjustments (e.g., for physical activity, physical health status and marital status) increase the difference. Adjustment for all 16 factors slightly increases the relative risk to 1.7 (p less than or equal to 0.001). These demographic and behavioral risk factors do not account for the overall sex difference in mortality rates. Examination of the interaction of biologic and behavioral risk factors may more fully explain the sex differential in mortality.
通过对加利福尼亚州阿拉米达县6928名成年人的随机样本进行1965年人口实验室调查，并进行为期九年的随访，按性别对死亡风险进行了研究，同时通过多元逻辑分析控制16种人口统计学和行为风险因素。风险因素包括年龄、种族、社会经济地位、职业、身体健康状况、医疗服务使用情况、吸烟、饮酒、体育活动、体重、睡眠模式、婚姻状况、社会交往、教会和团体成员身份以及生活满意度。每个因素的患病率和相对死亡风险共同影响性别差异。未调整的男性与女性相对死亡风险为1.5（p≤0.001）。对某些因素（如吸烟和饮酒）进行调整会减小这种差异，而其他调整（如体育活动、身体健康状况和婚姻状况）则会增加这种差异。对所有16个因素进行调整后，相对风险略有增加至1.7（p≤0.001）。这些人口统计学和行为风险因素并不能解释死亡率的总体性别差异。对生物和行为风险因素的相互作用进行研究可能会更全面地解释死亡率的性别差异。
