美国各县感染病死亡率的趋势和差异模式,1980-2014年
Charbel El Bcheraoui1, Ali H Mokdad1, Laura Dwyer-Lindgren1
1Institute for Health Metrics and Evaluation, University of Washington, Seattle.
JAMA
|March 28, 2018
概括
从1980年至2014年,美国的传染病死亡率总体上有所下降,但县级的显著差异仍然存在. 腹疾病显著增加, 造成越来越多的公共健康问题.
科学领域:
- 公共卫生
- 流行病学
- 传染性疾病
背景情况:
- 传染病仍然是美国的重大公共卫生挑战.
- 县级传染病死亡率数据并不容易获得.
- 估计这些趋势对于有针对性的公共卫生干预至关重要.
研究的目的:
- 从1980年到2014年,估计美国特定传染病的年龄标准化死亡率和趋势.
- 确定美国各县传染病死亡率的地理差异.
主要方法:
- 使用来自国家卫生统计中心 (NCHS) 和人口数据的非身份死亡记录.
- 将验证的小面积估计模型应用于县级数据.
- 分析了下呼吸道感染,腹疾病,艾滋病毒/艾滋病,脑膜炎,肝炎和结核病的死亡率.
主要成果:
- 在1980年至2014年期间,总体传染病死亡率下降了18.73%.
- 下呼吸道感染是2014年死亡的主要原因.
- 死亡率在各县有显著的差异,其中艾滋病毒/艾滋病的相对不平等程度最高.
结论:
- 虽然总体上传染病死亡率有所下降,但仍存在很大的地理差异.
- 脑膜炎和结核病的死亡率在所有县都下降.
- 在2000年至2014年期间,腹病死亡率上升,突出显示了特定地区的令人担忧的趋势.
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