哥伦比亚特区死亡率的人口差异
Maryam Hashemian1, Katherine M Conners1, Jungnam Joo2
1Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
JAMA network open
|March 28, 2025
概括
华盛顿特区的种族差异显示,黑人人口的心血管疾病 (CVD) 和癌症死亡率正在恶化. 关键心血管疾病风险因素在黑人中仍然更为普遍,需要针对性的公共卫生干预措施.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 心血管疾病研究研究
背景情况:
- 华盛顿特区在美国主要城市中,黑人和白人人口之间的预期寿命差距最大.
- 调查死亡率和心血管疾病 (CVD) 风险因素的差异对于这个城市环境中的公共卫生至关重要.
研究的目的:
- 检查2000年至2020年期间华盛顿特区非西班牙裔黑人和非西班牙裔白人人口的死亡率和可修改心血管疾病 (CVD) 风险因素的时间趋势.
- 量化所有原因和特定原因死亡率的种族差异以及关键心血管疾病风险因素的患病率.
主要方法:
- 这是一项横截面研究,利用流行病学研究 (WONDER) 广泛在线数据数据库的死亡率数据和行为风险因素监测系统 (BRFSS) 的风险因素流行率.
- 对年龄调整后的死亡率和风险因素 (肥胖,高血压,糖尿病,吸烟,高胆固醇血症) 的流行率的分析,比较2000年至2020年的黑人和白人人口.
- 结点回归被用来评估年平均百分比变化 (AAPC) 和差异趋势 (利率比).
主要成果:
- 从2000年到2012年,全因死亡率下降,停滞不前,然后从2018年到2020年增加. 心血管疾病 (CVD) 死亡率在白人人口中下降,但在黑人人口中停滞不前,扩大了差异 (RR 1.5 到 2.9).
- 癌症死亡率在两种人群中都下降,但在白人人口中降幅更大,也增加了差异 (RR 1.6至2.1).
- 在整个研究期间,心血管疾病风险因素,包括高血压,在黑人群体中相比白人群体更普遍.
结论:
- 华盛顿特区黑人人口的全因,年龄调整后死亡率更高,心血管疾病和癌症的种族差异越来越严重.
- 黑人人口中心血管疾病风险因素的持续更高的患病率有助于这些日益扩大的健康不平等.
- 迫切需要针对高风险人群的精确公共卫生干预措施,以解决这些显著和日益增长的差异.
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