米国における死亡率の時間的傾向,1969年−2013年
Jiemin Ma1, Elizabeth M Ward2, Rebecca L Siegel1
1Surveillance and Health Services Research Program, Intramural Research Department, American Cancer Society, Atlanta, Georgia.
JAMA
|October 28, 2015
まとめ
米国の死亡率は,慢性閉塞性肺疾患 (COPD) を除き,ほとんどの主要な原因で1969年から2013年の間に減少した. 近年,心臓病,脳卒中,糖尿病の減少は緩やかになり,公衆衛生上の課題の進化を強調しています.
科学分野:
- 公衆衛生
- 流行病学
- バイオ統計学
背景:
- 長期的な死亡傾向の評価は,健康計画と変更可能なリスク要因の特定に不可欠です.
- 主要な死因のタイムトレンドを理解することで 公衆衛生戦略とリソースの配分ができます
研究 の 目的:
- 死亡率の長期的傾向を分析する.
- 年齢を基準にした死亡率の変化と 75歳までに失われる可能性のある寿命の年数を特定する.
主な方法:
- 1969年から2013年までの米国の国家生命統計データに関する結合点分析を用いた.
- 年齢で標準化された死亡率と あらゆる原因で失われる可能性のある寿命の年数,心臓病,癌,COPD,脳卒中,意図しない怪我,糖尿病
主要な成果:
- すべての原因 (42. 9%),脳卒中 (77. 0%),心臓病 (67. 5%),意図しない傷害 (39. 8%),癌 (17. 9%) および糖尿病 (16. 5%) で年齢標準化された死亡率の有意な減少が観察されました.
- 対照的に,慢性閉塞性肺疾患 (COPD) の死亡率は2倍以上 (100.6%) 増加しました.
- 最近の動向は,心臓病,脳卒中,糖尿病による死亡率が減少し,男性におけるCOPDの死亡率は低下し始めていることを示しています.
結論:
- 1969年から2013年の間に,米国の死亡傾向は,ほとんどの主要な原因で全体的に減少しましたが,COPD死亡率は顕著に増加しました.
- 特定の原因による減速は 継続的なモニタリングと適応的な公衆衛生介入の必要性を示唆しています
- 死亡傾向のダイナミックな性質と,変更可能な要因に関する継続的な研究の重要性を強調しています.
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