Trends in "Deaths of Despair" Among Working-Aged White and Black Americans, 1990-2017.
Trends in "Deaths of Despair" Among Working-Aged White and Black Americans, 1990-2017.
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1990-2017 年美国劳动年龄白人和黑人“绝望死亡”的趋势。
DOI：
10.1093/aje/kwab088
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发表时间：
2021
影响因子：
5
通讯作者：
Masters,RyanK
中科院分区：
文献类型：
--
作者：
Tilstra,AndreaM;Simon,DanielH;Masters,RyanK
2013 年至 2017 年间，美国白人男性和女性的预期寿命有所下降。对这一下降的最初解释集中在“绝望死亡”（即因自杀、吸毒和酗酒而死亡）的增加，这被解释为一种困扰美国中年白人的队列现象。人们很少关注这些相同原因造成的黑人死亡率趋势，以及不同群体和时期的趋势是否相似或不同。我们补充了现有的研究，并认为美国黑人和白人最近的死亡率趋势很可能反映了不同时期的暴露情况：1) 美国阿片类药物流行和 2) 大衰退。我们分析了 1990 年至 2017 年美国 20 岁至 64 岁非西班牙裔黑人和非西班牙裔白人因自杀、吸毒和饮酒而死亡的具体原因死亡率趋势。我们采用性别、种族和死因分层泊松率模型和年龄阶段队列模型来比较死亡率趋势。结果表明，自 20 世纪 90 年代末以来，美国黑人和白人“绝望死亡”人数的增加，很大程度上是由于毒品相关死亡人数逐年增加所致。此外，尽管不同群体之间存在一些种族差异，但在大衰退期间，美国白人和黑人与饮酒和自杀相关的死亡人数发生了变化。
Life expectancy for US White men and women declined between 2013 and 2017. Initial explanations for the decline focused on increases in “deaths of despair” (i.e., deaths from suicide, drug use, and alcohol use), which have been interpreted as a cohort-based phenomenon afflicting middle-aged White Americans. There has been less attention on Black mortality trends from these same causes, and whether the trends are similar or different by cohort and period. We complement existing research and contend that recent mortality trends in both the US Black and White populations most likely reflect period-based exposures to 1) the US opioid epidemic and 2) the Great Recession. We analyzed cause-specific mortality trends in the United States for deaths from suicide, drug use, and alcohol use among non-Hispanic Black and non-Hispanic White Americans, aged 20–64 years, over 1990–2017. We employed sex-, race-, and cause-of-death–stratified Poisson rate models and age-period-cohort models to compare mortality trends. Results indicate that rising “deaths of despair” for both Black and White Americans are overwhelmingly driven by period-based increases in drug-related deaths since the late 1990s. Further, deaths related to alcohol use and suicide among both White and Black Americans changed during the Great Recession, despite some racial differences across cohorts.