Schott J
Institut und Poliklinik für Arbeitsmedizin und Sozialmedizin/Abt. Sozialmedizin, Med. Fak. Carl Gustav Carus der TU Dresden.
Gesundheitswesen. 1998 Jul;60(7):406-14.
We conducted a specific table analysis on mortality causes that was mainly oriented on the lines of the chapters of ICD-9 to explore the average life expectancy for the population in Saxony particularly since 1988. The drop in average life expectancy of males observed since 1990 can be fully explained only for those around 18 years of age by "accidents" as the cause of death. Between 30 and 55 years of age there were additional losses of average life expectancy via the mortality causes "diseases of the digestive tract", "neoplasms" and "psychiatric diseases". The significance of neoplasms and of psychiatric diseases is receeding in respect of the average life expectancy. In 1991 there was an increase in the incidence of suicide in the age bracket around 51 years in males. Seen on an overall scale across all age brackets the development of the suicide rate has increased average life expectancy. Significant average life expectancy increase developed in the range of death causes due to embryonic or congenital damage as well as cardiovascular diseases, diseases of the respiratory system and infectious diseases. As far as the female population is concerned, only accidents and diseases of the digestive tract had a negative effect on average life expectancy in 1990 and 1991 whereas the negative effect exercised by the mortality cause "neoplasms" is systematically flattening out. There are excessive gains in life expectancy in respect of cardiovascular diseases, clearly in the range of embryonal and congenital diseases and remarkably in respect of suicide. How many of these specific differentiations of causes of death are due to changes in coding, has not yet been assessed. Leaving aside the unnatural causes of death these figures point to a marked influence of improved medical care on average life expectancy.
我们针对死亡原因进行了一项特定的表格分析,主要依据国际疾病分类第九版(ICD - 9)各章节进行,以探究萨克森州自1988年以来的人口平均预期寿命。自1990年观察到的男性平均预期寿命下降情况,仅对于18岁左右的人群而言,可完全归因于“意外事故”作为死亡原因。在30至55岁之间,由于“消化道疾病”“肿瘤”和“精神疾病”等死亡原因,平均预期寿命出现了额外损失。肿瘤和精神疾病对平均预期寿命的影响正在减弱。1991年,51岁左右男性的自杀发生率有所上升。从所有年龄段的总体情况来看,自杀率的变化提高了平均预期寿命。由于胚胎或先天性损伤以及心血管疾病、呼吸系统疾病和传染病导致的死亡原因范围内,平均预期寿命有显著增长。就女性人口而言,1990年和1991年只有意外事故和消化道疾病对平均预期寿命产生了负面影响而死亡原因“肿瘤”所产生的负面影响正在系统性地减弱。在心血管疾病方面,预期寿命有过多增长,在胚胎和先天性疾病范围内明显如此,在自杀方面也显著如此。这些死亡原因的特定差异中有多少是由于编码变化所致,尚未得到评估。抛开非自然死亡原因不谈,这些数据表明医疗保健的改善对平均预期寿命有显著影响。