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失踪的美国人:美国的早期死亡-1933-2021年
Jacob Bor1, Andrew C Stokes1, Julia Raifman2
1Department of Global Health, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118, USA.
PNAS nexus
|June 12, 2023
概括
在2020-2021年,超过100万名"失踪的美国人"因美国死亡率高于同行国家而死亡. 避免这些过度死亡,特别是在65岁以下的人群中,将挽救数百万人的生命.
科学领域:
- 公共卫生 公共卫生
- 对比性死亡率分析
- 卫生经济学 卫生经济学
背景情况:
- 美国在历史上有较低或相似的死亡率与同行国家相比,直到20世纪80年代.
- 自20世纪80年代以来,美国的过度死亡人数大幅增加,被称为"失踪的美国人".
- 在COVID-19大流行期间,这种趋势急剧加快.
研究的目的:
- 通过比较美国年龄特定死亡率与21个同行国家的年龄特定死亡率来量化1933-2021年美国过度死亡人数.
- 分析随着时间的推移"失踪的美国人"的趋势,并确定不成比例地受到影响的人口群体.
- 为了估计潜在的生命和生命的失去了可能会被避免的岁月.
主要方法:
- 从1933年到2021年,对美国和21个富裕国家的年龄特定死亡率进行比较分析.
- 通过从美国死亡率中减去同行国家死亡率来计算美国的过剩死亡率.
- 估计由于过度死亡率而丧失的生命年数 (YLL).
主要成果:
- 从20世纪80年代开始,美国的"失踪美国人"数量大幅增加,到2019年超过622,000人.
- 在COVID-19大流行期间,过度死亡人数激增,在2020年和2021年超过100万.
- 65岁以下的个体的死亡率特别高,其中一半的死亡和2019-2021年增长的90%可能是可以避免的.
- 2021年,由于美国死亡率过高,损失了2640万年的生命,其中49%的死亡发生在65岁之前.
- 虽然黑人和美洲原住民承担了不成比例的负担,但大多数"失踪的美国人"是白人.
结论:
- 与同行国家相比,美国的过度死亡率负担显著且越来越大,特别是自20世纪80年代以来.
- 这种过度死亡率具有深远的影响,特别是在年轻人群中,并导致大量生命失去了.
- 解决美国较高死亡率的驱动因素对于改善公共卫生和减少可预防的死亡至关重要.
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