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[JAMA发表论文]:美国成年白人与黑人教育程度与死因的相关性
2019年09月12日 研究点评, 进展交流 暂无评论

Original Investigation August 27, 2019

Association Between Educational Attainment and Causes of Death Among White and Black US Adults, 2010-2017

Isaac Sasson, Mark D. Hayward

JAMA. 2019;322(8):756-763. doi:10.1001/jama.2019.11330

Abstract

Importance 背景

There are substantial and increasing educational differences in US adult life expectancy. To reduce social inequalities in mortality, it is important to understand how specific causes of death have contributed to increasing educational differences in adult life expectancy in recent years.

美国成年人教育程度与预期寿命具有显著相关性,且差异越来越大。为降低病死率的社会不均衡性,了解特异死因对成年人预期寿命近年来不断增加的教育背景差异造成的影响非常重要。

Objective 目的

To estimate the relationship of specific causes of death with increasing educational differences in adult life expectancy from 2010 to 2017.

了解2010至2017年特异死因与成年人预期寿命不断增加的教育背景差异之间的相关性。

Design, Setting, and Participants 试验设计,场景和研究对象

Serial cross-sectional study of 4 690 729 deaths recorded in the US National Vital Statistics System in 2010 and 2017.

2010年和2017年美国国家生命统计系统记录的4690729例死亡的系列横断面研究。

Exposures 暴露因素

Sex, race/ethnicity, and educational attainment.

性别,种族及教育背景

Main Outcomes and Measures 主要预后指标

Life expectancy at age 25 years and years of life lost between ages 25 and 84 years by cause of death.

25岁预期寿命,以及25岁至84岁间不同死因的生命损失年。

Results 结果

The analysis included a total of 2 211 633 deaths in 2010 and 2 479 096 deaths in 2017. Between 2010 and 2017, life expectancy at age 25 significantly declined among white and black non-Hispanic US residents from an expected age at death of 79.34 to 79.15 years (difference, −0.18 [95% CI, −0.23 to −0.14]). Greater decreases were observed among persons with a high school degree or less (white men: −1.05 years [95% CI, −1.15 to −0.94], white women: −1.14 years [95% CI, −1.24 to −1.04], and black men: −0.30 years [95% CI, −0.56 to −0.04]). White adults with some college education but no 4-year college degree experienced similar declines in life expectancy (men: −0.89 years [95% CI, −1.07 to −0.73], women: −0.59 years [95% CI, −0.77 to −0.42]). In contrast, life expectancy at age 25 significantly increased among the college-educated (white men: 0.58 years [95% CI, 0.42 to 0.73], white women: 0.78 years [95% CI, 0.57 to 1.00], and black women: 1.70 years [95% CI, 0.91 to 2.53]). The difference between high- and low-education groups increased from 2010 to 2017, largely because life-years lost to drug use increased among those with a high school degree or less (white men: 0.93 years [95% CI, 0.90 to 0.96], white women: 0.50 years [95% CI, 0.47 to 0.52], black men: 0.75 years [95% CI, 0.71 to 0.79], and black women: 0.28 years [95% CI, 0.25 to 0.31]).

分析纳入2010年 2 211 633例死亡以及2017年的 2 479 096 例死亡。2010年至2017年间,美国白人及黑人(非西班牙裔)25岁的预期寿命显著降低,从 79.34 岁下降到 79.15 岁(差异,−0.18 [95% CI, −0.23 to −0.14])。高中及高中以下学历人群下降嗯给显著(白人男性:−1.05 岁 [95% CI, −1.15 to −0.94],白人女性:−1.14 岁 [95% CI, −1.24 to −1.04],黑人男性:−0.30 岁 [95% CI, −0.56 to −0.04])。接受一定程度大学教育(非四年制大学教育)的白人预期寿命也有相似程度的降低(男性:−0.89 岁 [95% CI, −1.07 to −0.73],女性:−0.59 岁 [95% CI, −0.77 to −0.42])。相比之下,接受大学教育的人群25岁预期寿命显著增加(白人男性:0.58 岁 [95% CI, 0.42 to 0.73],白人女性:0.78 岁 [95% CI, 0.57 to 1.00],黑人女性:1.70 岁 [95% CI, 0.91 to 2.53])。从2010年至2017年,较高与较低教育程度人群的差异显著增加,主要由于高中及以下教育背景人群药物使用相关的生命损失年增加(白人男性:0.93 岁 [95% CI, 0.90 to 0.96],白人女性:0.50 岁 [95% CI, 0.47 to 0.52],黑人男性:0.75 岁 [95% CI, 0.71 to 0.79],黑人女性:0.28 岁 [95% CI, 0.25 to 0.31])。

Conclusions and Relevance 结论及意义

In this serial cross-sectional study, estimated life expectancy at age 25 years declined overall between 2010 and 2017; however, it declined among persons without a 4-year college degree and increased among college-educated persons. Much of the increasing educational differences in years of life lost may be related to deaths attributed to drug use.

在这一系列横断面研究中,2010年至2017年间,25岁预期寿命总体下降;然而,这一下降主要在没有接受4年大学教育的人群,而接受大学教育人群预期寿命反而增加。生命损失年的教育背景差异逐渐增加,主要与药物使用造成的死亡相关。

评论[仅代表个人观点]

  • 再次说明接受教育尤其是高等教育的重要性
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