Changes in patterns of mortality rates and years of life lost due to firearms in the United States, 1999 to 2016: A joinpoint analysis
Changes in patterns of mortality rates and years of life lost due to firearms in the United States, 1999 to 2016: A joinpoint analysis
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DOI：
10.1371/journal.pone.0225223
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发表时间：
2019-11-22
期刊：
影响因子：
3.7
通讯作者：
Kalesan, Bindu
中科院分区：
文献类型：
--
作者：
Bailey, Hannah M.;Zuo, Yi;Kalesan, Bindu
背景
与枪支相关的死亡率以及潜在寿命损失年数（YPLL）在不同人群亚组和州之间差异很大。然而，亚组和州内时间趋势的变化或拐点并未得到充分记录。我们评估了1999年至2016年期间美国总体以及按性别、年龄、种族/族裔、意图和州分类的枪支死亡率和因枪支导致的%YPLL的时间模式和拐点。
方法
我们使用WONDER（流行病学研究广泛在线数据）数据库提取了1999年至2016年每10万人的年龄调整后的枪支死亡率和YPLL率以及%YPLL。我们使用连接点回归来评估1999年至2016年的时间趋势、拐点和年度百分比变化（APC）。
结果
1999年和2016年全国枪支死亡率分别为每10万人10.3例和11.8例，有两个不同阶段；到2014年处于平稳期，之后APC增长7.2%（95%置信区间3.1，11.4）。1999年和2016年YPLL率分别为304.7和338.2，从1999年到2014年的拐点，%YPLL的APC稳定增长0.65%（95%置信区间0.43，0.87），之后%YPLL的APC更大，为5.1%（95%置信区间0.1，10.4）。从2014年开始的枪支死亡率和YPLL率上升趋势在男性、非西班牙裔黑人、西班牙裔白人亚组以及枪支袭击事件中均有观察到。枪支死亡率和YPLL率的拐点在各州之间也有所不同。
结论
在美国，1999年至2014年期间枪支死亡率和YPLL保持稳定，随后一直在上升。然而，一些亚组和个别州的枪支死亡率在2014年之前就已经上升。
BackgroundFirearm-related death rates and years of potential life lost (YPLL) vary widely between population subgroups and states. However, changes or inflections in temporal trends within subgroups and states are not fully documented. We assessed temporal patterns and inflections in the rates of firearm deaths and %YPLL due to firearms for overall and by sex, age, race/ethnicity, intent, and states in the United States between 1999 and 2016.MethodsWe extracted age-adjusted firearm mortality and YPLL rates per 100,000, and %YPLL from 1999 to 2016 by using the WONDER (Wide-ranging Online Data for Epidemiologic Research) database. We used Joinpoint Regression to assess temporal trends, the inflection points, and annual percentage change (APC) from 1999 to 2016.ResultsNational firearm mortality rates were 10.3 and 11.8 per 100,000 in 1999 and 2016, with two distinct segments; a plateau until 2014 followed by an increase of APC = 7.2% (95% CI 3.1, 11.4). YPLL rates were from 304.7 and 338.2 in 1999 and 2016 with a steady APC increase in %YPLL of 0.65% (95% CI 0.43, 0.87) from 1999 to an inflection point in 2014, followed by a larger APC in %YPLL of 5.1% (95% CI 0.1, 10.4). The upward trend in firearm mortality and YPLL rates starting in 2014 was observed in subgroups of male, non-Hispanic blacks, Hispanic whites and for firearm assaults. The inflection points for firearm mortality and YPLL rates also varied across states.ConclusionsWithin the United States, firearm mortality rates and YPLL remained constant between 1999 and 2014 and has been increasing subsequently. There was, however, an increase in firearm mortality rates in several subgroups and individual states earlier than 2014.