美国主要死亡原因的县级死亡率趋势,1980-2014年
Laura Dwyer-Lindgren1, Amelia Bertozzi-Villa1, Rebecca W Stubbs1
1Institute for Health Metrics and Evaluation, University of Washington, Seattle.
JAMA
|December 14, 2016
概括
美国各县的死亡率在所有死亡原因上都存在显著的地理差异. 这项研究揭示了1980年至2014年的不同模式和趋势,强调了有针对性的公共卫生干预措施的必要性.
科学领域:
- 流行病学
- 生物统计学
- 公共卫生
背景情况:
- 县级死亡数据对于公共卫生至关重要,但缺乏系统描述.
- 为了有效的干预, 需要对健康结果的地理差异进行详细分析.
研究的目的:
- 开发和应用一个新的美国县级死亡率估计方法.
- 从1980年到2014年, 分析美国各县21种死亡原因的年均死亡率.
主要方法:
- 使用国家生命统计系统数据的重新分配和小面积估计方法.
- 采用查方法,以确保特定原因和国家估计的一致性.
- 特定的地理模式和年龄标准化死亡率的变化.
主要成果:
- 分析了美国3110个县的800多万例死亡情况.
- 在所有21种死亡原因中观察到县间显著的差异.
- 确定了心血管疾病,自我伤害,暴力和呼吸系统疾病的不同地理模式.
结论:
- 所有原因的死亡率都存在很大的县级差异,地理分布各不相同.
- 小区域建模方法为美国疾病特异性死亡率趋势和区域差异提供了新的见解.
- 这些发现强调了通过有针对性的战略解决地理健康差异的重要性.
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