Educational disparities in mortality among adults with diabetes in the U.S.
Educational disparities in mortality among adults with diabetes in the U.S.
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DOI：
10.2337/dc09-2094
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发表时间：
2010-06
期刊：
影响因子：
16.2
通讯作者：
Brancati FL
中科院分区：
文献类型：
--
作者：
Dray-Spira R;Gary-Webb TL;Brancati FL
衡量美国成人糖尿病患者死亡率的相对和绝对教育差异，并将其大小与非糖尿病人群中观察到的差异进行比较。截至 2002 年 12 月 31 日，共有 85,867 名年龄在 35-84 岁之间的个人（其中 5,007 名患有糖尿病）参加了全国健康访谈调查，他们的死亡率得到了追踪。对全因死亡率、心血管疾病死亡率和非 CVD 死亡率的相对和绝对教育差异进行了测量。相对而言，教育程度最低的糖尿病成人的全因死亡风险比教育程度最高的成人高 28%（相对不平等指数 1.28 [95% CI 1.08–1.53]）。这种负相关关系反映了心血管疾病死亡率的显着差异，并且在除西班牙裔以外的所有年龄、性别和种族/族裔群体中都存在这种关系。尽管很大，但成人糖尿病患者死亡率的相对教育梯度小于非糖尿病人群。从绝对值来看，与教育程度最高的糖尿病成人相比，每 10,000 人年随访中，教育程度最低的糖尿病成人多死亡 503 人。这些绝对差异比非糖尿病人群更大。 CVD 死亡率的结果更为惊人。在美国，根据教育水平的不同，美国糖尿病患者的死亡风险存在很大差异。虽然成人糖尿病患者的死亡率的相对教育差异较小，但其绝对影响更大，并转化为主要的死亡负担。
To measure relative and absolute educational disparities in mortality among U.S. adults with diabetes and to compare their magnitude with disparities observed within the nondiabetic population. A total of 85,867 individuals (5,007 with diabetes), aged 35–84 years, who participated in the National Health Interview Survey from 1986 to 1996 were followed for mortality through 31 December 2002. Relative and absolute educational disparities in all-cause, cardiovascular disease (CVD), and non-CVD mortality were measured. In relative terms, the risk of all-cause mortality was 28% higher in diabetic adults with the lowest versus the highest position on the educational scale (relative index of inequality 1.28 [95% CI 1.08–1.53]). This inverse relationship reflected marked disparities in CVD mortality and was found in all age, sex, and race/ethnicity groups except Hispanics. Although substantial, this relative educational gradient in mortality among adults with diabetes was smaller than in the nondiabetic population. In absolute terms, diabetic adults with the lowest position on the educational scale suffered 503 excess deaths per 10,000 person-years of follow-up compared with those with the highest position. These absolute disparities were stronger than in the nondiabetic population. The results were even more striking for CVD mortality. The risk of mortality differs substantially according to educational level among individuals with diabetes in the U.S. Although relative educational disparities in mortality are weaker in adults with versus without diabetes, their absolute impact is greater and translates into a major mortality burden.
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DOI：
10.1073/pnas.0611234104
发表时间：
2007-08-14
影响因子：
11.1
作者：
Smith, James P.
通讯作者：
Smith, James P.
影响因子：
16.2
作者：
Cowie, Catherine C.;Engelgau, Michael M.;Gregg, Edward W.
通讯作者：
Gregg, Edward W.
影响因子：
16.2
作者：
McEwen, Laura N.;Kim, Catherine;Herman, William H.
通讯作者：
Herman, William H.
影响因子：
7.2
作者：
Okura, Y;Urban, LH;Rodeheffer, RJ
通讯作者：
Rodeheffer, RJ
影响因子：
12.7
作者：
Goldman, Noreen;Kimbro, Rachel T.;Pebley, Anne R.
通讯作者：
Pebley, Anne R.