Lai D, Tsai S P, Hardy R J
School of Public Health, University of Texas, Houston 77030, USA.
AIDS. 1997 Feb;11(2):203-7. doi: 10.1097/00002030-199702000-00011.
The potential gains in life expectancy of the US population by the partial and total elimination of deaths from HIV/AIDS were compared with that of deaths from heart disease and malignant neoplasms.
The data from the 1992 advanced mortality report and detailed information provided by the National Center for Health Statistics were analysed by using the partial multiple decrement life-table technique.
For the total population of the United States in 1992, the gains in future life expectancy through the elimination of deaths from HIV/AIDS, heart disease and malignant neoplasms were 0.34, 3.25 and 3.21 years, respectively. The gains in life expectancy in those of working age 15-64 years) through the elimination of deaths from these three causes of deaths were 0.20, 0.40 and 0.55 years, respectively. Race/sex-specific calculations indicate that the total elimination of deaths from HIV/AIDS, heart disease and malignant neoplasms in white men of working age resulted in increased life expectancy of 0.28, 0.54 and 0.53, respectively, whereas the corresponding figures for black men were 0.82, 0.90 and 0.76 years, respectively. Although the impact of the elimination of the other causes remained relatively stable from 1987 to 1992, the potential gains in life expectancy for black men of working age by eliminating HIV/AIDS rose from 0.36 years in 1987 to 0.82 years in 1992. For the total US population of working age, the elimination of HIV/AIDS deaths resulted in increased life expectancy similar to that observed for a 50% reduction of heart disease or malignant neoplasms, whereas among black men of working age, the increased years of life expectancy from the elimination of HIV/AIDS deaths were virtually the same as those observed for the elimination of heart disease or malignant neoplasms.
The potential gains in life expectancy by reduction of deaths from heart disease and malignant neoplasms are more heavily influenced by increasing years after the working ages (15-64 years), whereas the potential gains in life expectancy by reducing deaths from HIV/AIDS make a greater contribution to those of working age. Hence, in terms of the economic costs and benefits, these results indicate that in evaluating policy issues regarding allocation of research funds, studies of life expectancy are far more important than the simple approach which allocates funds on the basis of the number of deaths due to various diseases.
将美国人群因部分或全部消除艾滋病病毒/艾滋病死亡所带来的预期寿命潜在增长,与心脏病和恶性肿瘤死亡所带来的预期寿命增长进行比较。
利用部分多重递减寿命表技术,对1992年的高级死亡率报告数据以及美国国家卫生统计中心提供的详细信息进行分析。
对于1992年的美国总人口,通过消除艾滋病病毒/艾滋病、心脏病和恶性肿瘤死亡所带来的未来预期寿命增长分别为0.34年、3.25年和3.21年。对于15 - 64岁工作年龄段人群,通过消除这三种死因所带来的预期寿命增长分别为0.20年、0.40年和0.55年。按种族/性别进行的计算表明,完全消除工作年龄段白人男性的艾滋病病毒/艾滋病、心脏病和恶性肿瘤死亡,预期寿命分别增加0.28年、0.54年和0.53年,而黑人男性的相应数字分别为0.82年、0.90年和0.76年。尽管从1987年到1992年消除其他死因的影响相对稳定,但消除艾滋病病毒/艾滋病使工作年龄段黑人男性的预期寿命潜在增长从1987年的0.36年升至1992年的0.82年。对于美国工作年龄段的总人口,消除艾滋病病毒/艾滋病死亡导致的预期寿命增长,与心脏病或恶性肿瘤死亡减少50%时观察到的增长相似,而在工作年龄段黑人男性中,消除艾滋病病毒/艾滋病死亡带来的预期寿命增加年数,与消除心脏病或恶性肿瘤死亡所观察到的增加年数几乎相同。
通过减少心脏病和恶性肿瘤死亡带来的预期寿命潜在增长,受工作年龄(15 - 64岁)之后年龄增长的影响更大,而通过减少艾滋病病毒/艾滋病死亡带来的预期寿命潜在增长,对工作年龄段人群的贡献更大。因此,从经济成本和效益方面来看,这些结果表明,在评估关于研究资金分配的政策问题时,预期寿命研究远比基于各种疾病死亡人数来分配资金的简单方法重要得多。