Racial and social class gradients in life expectancy in contemporary California
Racial and social class gradients in life expectancy in contemporary California
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DOI：
10.1016/j.socscimed.2010.01.003
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发表时间：
2010-05-01
影响因子：
5.4
通讯作者：
Gomez, Scarlett L.
中科院分区：
文献类型：
--
作者：
Clarke, Christina A.;Miller, Tim;Gomez, Scarlett L.
预期寿命或估计的平均死亡年龄是衡量人口健康的最基本指标之一。然而，至少在美国，监测社会人口学定义的人群的预期寿命差异一直具有挑战性，因为死亡证明不包括社会经济地位（SES）标志的收集。为了了解社会经济状况和种族/民族如何独立和共同影响当代美国人口的整体健康，我们对加利福尼亚州在1999-2001年的三年期间（与最近的美国人口普查重叠）发生的所有689,036例死亡进行了基于小区域的社会经济状况测量。死亡时居住地按可用的最小人口普查区域（街区组）进行地理编码，并分配到多因子SES指数的五分位数。我们使用按年龄、性别、种族/民族和社区社会经济地位五分位数计算的死亡率构建了生命表，并产生了相应的预期寿命估计值。我们发现，在预期寿命最长（社会经济地位最高的亚洲女性为84.9岁）和最短（社会经济地位最低的非洲裔美国男性为65.3岁）的社会人口统计学群体之间，预期寿命差距为19.6（+/- 0.6）岁。在白人和非裔美国人中观察到预期寿命的正SES梯度，但在西班牙裔和亚洲人中则没有。不同年龄组的死亡率差异各不相同。种族/民族和社区社会经济状况对预期寿命有重大和独立的影响，强调了同时监测这些因素的健康结果的重要性。生活在加州最贫穷的20%社区的非裔美国男性的预期寿命与生活在发展中国家的男性相当。社区SES是美国持续监测健康差异的现成指标。(C) 2010 Elsevier Ltd.版权所有。
Life expectancy, or the estimated average age of death, is among the most basic measures of a population's health. However, monitoring differences in life expectancy among sociodemographically defined populations has been challenging, at least in the United States (US), because death certification does not include collection of markers of socioeconomic status (SES). In order to understand how SES and race/ethnicity independently and jointly affected overall health in a contemporary US population, we assigned a small-area-based measure of SES to all 689,036 deaths occurring in California during a three-year period (1999-2001) overlapping the most recent US census. Residence at death was geocoded to the smallest census area available (block group) and assigned to a quintile of a multifactorial SES index. We constructed life tables using mortality rates calculated by age, sex, race/ethnicity and neighborhood SES quintile, and produced corresponding life expectancy estimates. We found a 19.6 (+/- 0.6) year gap in life expectancy between the sociodemographic groups with the longest life expectancy (highest SES quintile of Asian females; 84.9 years) and the shortest (lowest SES quintile of African-American males; 65.3 years). A positive SES gradient in life expectancy was observed among whites and African-Americans but not Hispanics or Asians. Age-specific mortality disparities varied among groups. Race/ethnicity and neighborhood SES had substantial and independent influences on life expectancy, underscoring the importance of monitoring health outcomes simultaneously by these factors. African-American males living in the poorest 20% of California neighborhoods had life expectancy comparable to that reported for males living in developing countries. Neighborhood SES represents a readily-available metric for ongoing surveillance of health disparities in the US. (C) 2010 Elsevier Ltd. All rights reserved.