Life expectancy and risk of death in 6791 communities in England from 2002 to 2019: high-resolution spatiotemporal analysis of civil registration data.
Life expectancy and risk of death in 6791 communities in England from 2002 to 2019: high-resolution spatiotemporal analysis of civil registration data.
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DOI：
10.1016/s2468-2667(21)00205-x
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发表时间：
2021-11
期刊：
影响因子：
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通讯作者：
Ezzati M
中科院分区：
文献类型：
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作者：
Rashid T;Bennett JE;Paciorek CJ;Doyle Y;Pearson-Stuttard J;Flaxman S;Fecht D;Toledano MB;Li G;Daby HI;Johnson E;Davies B;Ezzati M
关于英国死亡率和寿命如何变化的高分辨率数据很少。我们的目标是估计2002年至2019年英格兰所有6791个中层超级产出区（MSOA）的预期寿命和不同年龄死亡概率的趋势。我们对来自英国小区域卫生统计单位研究数据库的民事登记数据进行了高分辨率时空分析，使用2002年至2019年英格兰所有死亡的去识别数据，包括年龄，性别和居住的MSOA信息，以及年龄，性别和MSOA的人口计数。我们使用贝叶斯分层模型通过跨年龄组、MSOA和年份共享信息来获得特定年龄死亡率的估计值。我们使用寿命表方法计算出生时的预期寿命和不同年龄的死亡概率，按性别和MSOA。在2002 - 2006年和2006 - 2010年，除了少数几个（0 - 1%）MSOA外，所有MSOA的女性和男性预期寿命都有所增加。2010 - 2014年，在6 791个MSOA中，351个（5.2%）女性预期寿命下降。到2014 - 19年，预期寿命下降的MSOA数量为女性1270人（18.7%），男性784人（11.5%）。从2002年到2019年的预期寿命增长在2002年预期寿命较低的MSOA中较小（主要是北方城市MSOA），而在2002年预期寿命较高的MSOA中较大（主要是伦敦及其周边地区的MSOA）。由于这些趋势，《最低生活保障法》第一条和第99条规定的妇女预期寿命之间的差距从10.7岁（95%可信区间10·4 - 10·9）2002年达到14·2年（13·9 - 14·5），男性从2002年的11·5年（11·3 - 11·7）增加到2019年的13·6年（13·4 - 13·9）。在2019冠状病毒病大流行前的十年，英格兰越来越多社区的预期寿命下降。为了确保这一趋势不再继续或恶化，需要采取有利于公平的经济和社会政策，并在全国范围内加大对公共卫生和保健的投资。惠康信托基金会、伦敦帝国理工学院、医学研究理事会、英国健康数据研究和国立卫生研究院。
High-resolution data for how mortality and longevity have changed in England, UK are scarce. We aimed to estimate trends from 2002 to 2019 in life expectancy and probabilities of death at different ages for all 6791 middle-layer super output areas (MSOAs) in England. We performed a high-resolution spatiotemporal analysis of civil registration data from the UK Small Area Health Statistics Unit research database using de-identified data for all deaths in England from 2002 to 2019, with information on age, sex, and MSOA of residence, and population counts by age, sex, and MSOA. We used a Bayesian hierarchical model to obtain estimates of age-specific death rates by sharing information across age groups, MSOAs, and years. We used life table methods to calculate life expectancy at birth and probabilities of death in different ages by sex and MSOA. In 2002–06 and 2006–10, all but a few (0–1%) MSOAs had a life expectancy increase for female and male sexes. In 2010–14, female life expectancy decreased in 351 (5·2%) of 6791 MSOAs. By 2014–19, the number of MSOAs with declining life expectancy was 1270 (18·7%) for women and 784 (11·5%) for men. The life expectancy increase from 2002 to 2019 was smaller in MSOAs where life expectancy had been lower in 2002 (mostly northern urban MSOAs), and larger in MSOAs where life expectancy had been higher in 2002 (mostly MSOAs in and around London). As a result of these trends, the gap between the first and 99th percentiles of MSOA life expectancy for women increased from 10·7 years (95% credible interval 10·4–10·9) in 2002 to reach 14·2 years (13·9–14·5) in 2019, and for men increased from 11·5 years (11·3–11·7) in 2002 to 13·6 years (13·4–13·9) in 2019. In the decade before the COVID-19 pandemic, life expectancy declined in increasing numbers of communities in England. To ensure that this trend does not continue or worsen, there is a need for pro-equity economic and social policies, and greater investment in public health and health care throughout the entire country. Wellcome Trust, Imperial College London, Medical Research Council, Health Data Research UK, and National Institutes of Health Research.