量化因COVID-19而丧失的生命年数的收入不平等:使用荷兰行政数据的预测模型方法
Jawa Issa1, Bram Wouterse1, Elena Milkovska1
1Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
International journal of epidemiology
|December 11, 2023
概括
COVID-19造成了显著的生命损失 (YLL),特别是在低收入群体中. 对先前存在的健康状况的计算揭示了更准确的YLL,突出了解决健康差异的政策的需要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 卫生经济学 卫生经济学
背景情况:
- 低社会经济地位和健康状况不佳增加了COVID-19死亡风险和失去了生命年 (YLL).
- 标准预期寿命高估了来自COVID-19的YLL,没有考虑到先前存在的条件.
- 准确的YLL量化对于理解与流行病相关的健康不平等至关重要.
研究的目的:
- 量化50岁以上荷兰人口中因COVID-19死亡而导致的YLL.
- 根据性别和收入四分位数分析YLL,并纳入个人健康状况.
- 用标准与健康调整的预期寿命来比较YLL估计.
主要方法:
- 利用2019年50岁以上的680万个人的广泛行政数据.
- 考虑年龄,性别,收入和医疗保健使用的模拟死亡概率.
- 预测COVID-19死者的死亡率和使用生命表计算的YLL.
主要成果:
- 标准预期寿命高估了YLL (167,315 YLL).
- 经健康调整后的年均收入较低 (100,743年均收入),其中40%在最贫穷的四分之一.
- 平均每人死亡年龄在最贫困和最富有四分位数之间差异很小,尽管最贫困的死亡年龄较小.
结论:
- 预先存在的健康状况显著影响COVID-19 YLL估计.
- 贫困人口中较高的COVID-19死亡率导致了人口层面的YLL不平等.
- 政策必须解决潜在的健康和暴露差异,以减轻未来的流行病负担.
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