Weathering, Drugs, and Whack-a-Mole: Fundamental and Proximate Causes of Widening Educational Inequity in US Life Expectancy by Sex and Race, 1990-2015
Weathering, Drugs, and Whack-a-Mole: Fundamental and Proximate Causes of Widening Educational Inequity in US Life Expectancy by Sex and Race, 1990-2015
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DOI：
10.1177/0022146519849932
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发表时间：
2019-06-01
影响因子：
5
通讯作者：
Timpe, Brenden
中科院分区：
文献类型：
--
作者：
Geronimus, Arline T.;Bound, John;Timpe, Brenden
关于美国预期寿命日益不平等的讨论越来越多地集中在流行的叙述上，即它是由“绝望死亡”的激增所驱动的。“这种叙述符合经验证据吗？使用人口普查和生命统计数据，我们应用生命表方法计算1990年和2015年非西班牙裔黑人和白人在25岁至84岁之间按性别和教育等级损失的特定原因寿命。吸毒过量确实对扩大白人，特别是男性的不平等做出了重要贡献，但对黑人来说微不足道。自杀对不平等加剧的贡献并不显著。心血管疾病、非肺癌和其他内在原因是解释预期寿命不平等加剧的关键。研究结果强调，试图将预期寿命不平等的趋势归因于绝望的流行是投机性的。他们呼吁继续调查顽强的高努力应对长期压力对边缘化人口健康的可能风化影响。
Discussion of growing inequity in U.S. life expectancy increasingly focuses on the popularized narrative that it is driven by a surge of "deaths of despair." Does this narrative fit the empirical evidence? Using census and Vital Statistics data, we apply life-table methods to calculate cause-specific years of life lost between ages 25 and 84 by sex and educational rank for non-Hispanic blacks and whites in 1990 and 2015. Drug overdoses do contribute importantly to widening inequity for whites, especially men, but trivially for blacks. The contribution of suicide to growing inequity is unremarkable. Cardiovascular disease, non-lung cancers, and other internal causes are key to explaining growing life expectancy inequity. Results underline the speculative nature of attempts to attribute trends in life-expectancy inequity to an epidemic of despair. They call for continued investigation of the possible weathering effects of tenacious high-effort coping with chronic stressors on the health of marginalized populations.