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老年黑人和白人的教育状况与健康预期寿命

Educational status and active life expectancy among older blacks and whites.

作者信息

Guralnik J M, Land K C, Blazer D, Fillenbaum G G, Branch L G

机构信息

Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, MD 20892.

出版信息

N Engl J Med. 1993 Jul 8;329(2):110-6. doi: 10.1056/NEJM199307083290208.

Abstract

BACKGROUND AND METHODS

Persons of low socioeconomic status are known to have reduced life expectancy. In a study of the relation of socioeconomic status to disability-free or active life expectancy among older persons, we analyzed prospectively gathered data on 2219 blacks and 1838 whites who were 65 years of age or older in the Piedmont region of North Carolina. We defined disability as the inability to perform independently one or more basic functional activities such as walking, bathing, dressing, eating, and using the toilet. For subgroups defined by sex, race, and education, statistical models were used to estimate, for persons at each year of age, the probability of transition from not being disabled or being disabled at base line to not being disabled, being disabled, or having died one year later. These transition probabilities were then entered into increment-decrement life tables to generate estimates of total, active, and disabled life expectancy (with total life expectancy equal to active life expectancy plus disabled life expectancy).

RESULTS

Sixty-five-year-old black men had a lower total life expectancy (11.4 years) and active life expectancy (10 years) than white men (total life expectancy, 12.6 years; active life expectancy, 11.2 years), although the differences were reduced after we controlled for education. The estimates for 65-year-old black women (total life expectancy, 18.7 years; active life expectancy, 15.9 years) were similar to those for white women. Black men and women 75 years old and older had higher values for total life expectancy and active life expectancy than whites, and the differences were larger after stratification for education. Education had a substantially stronger relation to total life expectancy and active life expectancy than did race. At the age of 65, those with 12 or more years of education had an active life expectancy that was 2.4 to 3.9 years longer than the values for those with less education in all the four subgroups defined by sex and race. Overall, the subgroups with longer total life expectancy and active life expectancy also lived more years with a disability.

CONCLUSIONS

Among older blacks and whites, the level of education, a measure of socioeconomic status, has a greater effect than race on total life expectancy and active life expectancy.

摘要

背景与方法

社会经济地位较低的人群预期寿命较短。在一项关于老年人社会经济地位与无残疾或积极预期寿命之间关系的研究中,我们前瞻性地分析了北卡罗来纳州皮埃蒙特地区2219名65岁及以上黑人以及1838名65岁及以上白人的数据。我们将残疾定义为无法独立进行一项或多项基本功能活动,如行走、洗澡、穿衣、进食和使用厕所。对于按性别、种族和教育程度定义的亚组,我们使用统计模型来估计各年龄组人群从基线时无残疾或有残疾状态转变为一年后无残疾、有残疾或死亡的概率。然后将这些转变概率代入增龄 - 减龄生命表,以得出总预期寿命、积极预期寿命和残疾预期寿命的估计值(总预期寿命等于积极预期寿命加上残疾预期寿命)。

结果

65岁的黑人男性总预期寿命(11.4年)和积极预期寿命(10年)低于白人男性(总预期寿命12.6年;积极预期寿命11.2年),不过在我们对教育程度进行控制后,差异有所减小。65岁黑人女性的估计值(总预期寿命18.7年;积极预期寿命15.9年)与白人女性相似。75岁及以上的黑人男性和女性的总预期寿命和积极预期寿命高于白人,并且在按教育程度分层后差异更大。教育程度与总预期寿命和积极预期寿命的关系比种族更为密切。65岁时,在按性别和种族定义的所有四个亚组中,接受12年或以上教育的人群的积极预期寿命比受教育程度较低者长2.4至3.9年。总体而言,总预期寿命和积极预期寿命较长的亚组残疾生存的年限也更多。

结论

在老年黑人和白人中,作为社会经济地位衡量指标的教育程度,对总预期寿命和积极预期寿命的影响大于种族。

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