The growing rural-urban divide in US life expectancy: contribution of cardiovascular disease and other major causes of death.
The growing rural-urban divide in US life expectancy: contribution of cardiovascular disease and other major causes of death.
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DOI：
10.1093/ije/dyab158
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发表时间：
2022-01-06
影响因子：
7.7
通讯作者：
Mehta NK
中科院分区：
文献类型：
--
作者：
Abrams LR;Myrskylä M;Mehta NK
随着时间的推移，美国农村在预期寿命（LE）方面相对于城市地区的劣势越来越大。我们测量了心血管疾病（CVD）、药物过量死亡（DODs）和其他主要死亡原因对农村和城市县LE趋势的贡献以及城乡LE差距。使用疾病控制和预防中心1999-2019年美国所有死亡数据（N = 51 998 560）构建了反事实生命表和死因分解。在1999-2009年期间，农村和城市县经历了强劲的寿命增长，但与农村县相比，城市县的女性寿命增加了1.19岁，男性寿命增加了0.86岁。在2010-2019年期间，农村县的平均寿命绝对下降（女性为- 0.20岁，男性为- 0.30岁），而城市县的平均寿命略有上升（女性为0.55岁，男性为0.29岁）。反事实分析表明，心血管疾病死亡率下降速度放缓，特别是65岁以上人群的死亡率下降，是2010年后农村LE停止增长的主要原因。然而，心血管疾病死亡率的缓慢进展对城市地区的LE趋势影响更大。如果心血管疾病死亡率继续以2010年前的速度下降，2010年后城乡人均寿命差距将进一步扩大。DODs和其他死亡原因也对每个时期的LE趋势和差异有影响，但与CVD相比，它们的影响相对较小。农村贫困人口继续增长，但增速低于2010年前。这种减缓更多地归因于城市地区心血管疾病和DOD死亡率的不利趋势，而不是农村地区的改善。
The US rural disadvantage in life expectancy (LE) relative to urban areas has grown over time. We measured the contribution of cardiovascular disease (CVD), drug-overdose deaths (DODs) and other major causes of death to LE trends in rural and urban counties and the rural–urban LE gap. Counterfactual life tables and cause-of-death decompositions were constructed using data on all US deaths in 1999–2019 (N = 51 998 560) from the Centers for Disease Control and Prevention. During 1999–2009, rural and urban counties experienced robust LE gains, but urban LE increased by 1.19 years more in women and 0.86 years more in men compared with rural LE. During 2010–2019, rural counties experienced absolute declines in LE (women −0.20, men −0.30 years), whereas urban counties experienced modest increases (women 0.55, men 0.29 years). Counterfactual analysis showed that slowed CVD-mortality declines, particularly in ages 65+ years, were the main reason why rural LE stopped increasing after 2010. However, slow progress in CVD-mortality influenced LE trends more in urban areas. If CVD-mortality had continued to decline at its pre-2010 pace, the rural–urban LE gap would have grown even more post 2010. DODs and other causes of death also contributed to the LE trends and differences in each period, but their impact in comparison to that of CVD was relatively small. Rural disadvantage in LE continues to grow, but at a slower pace than pre 2010. This slowdown is more attributable to adverse trends in CVD and DOD mortality in urban areas than improvements in rural areas.
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影响因子：
2.4
作者：
Monnat, Shannon M.
通讯作者：
Monnat, Shannon M.
影响因子：
2.5
作者：
Elo, Irma T.;Hendi, Arun S.;Preston, Samuel H.
通讯作者：
Preston, Samuel H.
影响因子：
5.5
作者：
Singh, Gopal K.;Siahpush, Mohammad
通讯作者：
Siahpush, Mohammad
心血管死亡率下降：可能的原因和影响。
影响因子：
20.1
作者：
Mensah GA;Wei GS;Sorlie PD;Fine LJ;Rosenberg Y;Kaufmann PG;Mussolino ME;Hsu LL;Addou E;Engelgau MM;Gordon D
通讯作者：
Gordon D
影响因子：
24.9
作者：
Garcia, Macarena C.;Faul, Mark;Iademarco, Michael F.
通讯作者：
Iademarco, Michael F.