米国の主要な死因における郡レベルの死亡率の傾向,1980年−2014年
Laura Dwyer-Lindgren1, Amelia Bertozzi-Villa1, Rebecca W Stubbs1
1Institute for Health Metrics and Evaluation, University of Washington, Seattle.
JAMA
|December 14, 2016
まとめ
アメリカの郡死亡率は,すべての死因で重要な地理的差異を示しています. この研究は,1980年から2014年にかけての様相と傾向を明らかにし, 対象を絞った公衆衛生介入の必要性を強調しています.
科学分野:
- 流行病学について
- バイオ統計学
- 公衆衛生
背景:
- 郡レベルの死亡率は公衆衛生にとって極めて重要ですが,体系的な記述は欠けています.
- 地理的な差異は 効果的な介入の詳細な分析を必要とします
研究 の 目的:
- 米国における死亡率の新しい郡レベルの推定方法を開発し,適用する.
- 1980年から2014年の米国各郡における 21の死因の年間死亡率を分析する.
主な方法:
- 国立生命統計システムデータに関する再配分と小面積の推定方法を使用した.
- 原因の特定と国の見積もりの一貫性を確保するために,RAKINGを適用します.
- 特定の地理的パターンと年齢基準の死亡率の変化
主要な成果:
- 3千110の郡で8千万件以上の死者を分析しました
- 死亡原因の21件で 郡間の格差が見られた
- 心血管疾患,自傷,暴力,呼吸器疾患の 明確な地理的パターンを特定しました
結論:
- 死亡率は郡レベルで大きく異なっており,地理的な分布も様々です.
- 小規模領域モデリングのアプローチは,米国における疾患特有の死亡率の傾向と地域的変動に関する新しい洞察を提供します.
- 地理的な健康格差を ターゲットに絞った戦略で解決することの重要性を 強調しています
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