研究分析拉丁美洲363个城市的预期寿命和死亡率
2021-01-28   阅读:374   来源:自然

2021年1月25日出版的《自然-医学》杂志发表了美国Drexel大学Dornsife公共卫生学院Usama Bilal研究组的最新研究成果。他们探究了拉丁美洲363个城市的预期寿命和死亡率。

利用SALURBAL项目的统一数据集,研究人员探究了9个拉美国家363个城市人口的预期寿命和死亡率的差异和预测因子。同一国家不同城市人口的预期寿命差异很大。特定原因的死亡率在城市之间也各不相同,某些死亡原因(无意和暴力伤害与死亡)在各国内部差异很大,而其他原因(传染性、孕产妇、新生儿和营养性、癌症、心血管疾病和其他非传染性疾病)造成的死亡也因国家/地区而异。

在多变量混合模型中,较高的教育程度、饮用干净水和卫生条件以及过度拥挤减弱与更长的预期寿命成正相关;相对较低的传染性、孕产妇、新生儿和营养性死亡比例以及由癌症、心血管疾病和非传染性疾病造成的死亡比例较高。这些结果突显了拉丁美洲各城市的预期寿命和死亡原因存在很大的异质性,揭示了可优化的因素,这些因素可能有利于改善拉丁美洲以及其他城市的健康城市政策。

据了解,所谓的健康优势城市忽略了整个城市健康结果可能存在的异质性。

附:英文原文

Title: Life expectancy and mortality in 363 cities of Latin America

Author: Usama Bilal, Philipp Hessel, Carolina Perez-Ferrer, Yvonne L. Michael, Tania Alfaro, Janeth Tenorio-Mucha, Amelia A. L. Friche, Maria Fatima Pina, Alejandra Vives, Harrison Quick, Marcio Alazraqui, Daniel A. Rodriguez, J. Jaime Miranda, Ana V. Diez-Roux

Issue&Volume: 2021-01-25

Abstract: The concept of a so-called urban advantage in health ignores the possibility of heterogeneity in health outcomes across cities. Using a harmonized dataset from the SALURBAL project, we describe variability and predictors of life expectancy and proportionate mortality in 363 cities across nine Latin American countries. Life expectancy differed substantially across cities within the same country. Cause-specific mortality also varied across cities, with some causes of death (unintentional and violent injuries and deaths) showing large variation within countries, whereas other causes of death (communicable, maternal, neonatal and nutritional, cancer, cardiovascular disease and other noncommunicable diseases) varied substantially between countries. In multivariable mixed models, higher levels of education, water access and sanitation and less overcrowding were associated with longer life expectancy, a relatively lower proportion of communicable, maternal, neonatal and nutritional deaths and a higher proportion of deaths from cancer, cardiovascular disease and other noncommunicable diseases. These results highlight considerable heterogeneity in life expectancy and causes of death across cities of Latin America, revealing modifiable factors that could be amenable to urban policies aimed toward improving urban health in Latin America and more generally in other urban environments. City-level analysis of data from the SALURBAL project shows vast heterogeneity in life expectancy across cities within the same country, in addition to substantive differences in causes of death among nine Latin American countries, revealing modifiable factors that could be leveraged by municipal-level policies aimed toward improving health in urban environments.

DOI: 10.1038/s41591-020-01214-4

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