Estimation of US Children's Educational Attainment and Years of Life Lost Associated With Primary School Closures During the Coronavirus Disease 2019 Pandemic.
Estimation of US Children's Educational Attainment and Years of Life Lost Associated With Primary School Closures During the Coronavirus Disease 2019 Pandemic.
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DOI：
10.1001/jamanetworkopen.2020.28786
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发表时间：
2020-11-02
影响因子：
13.8
通讯作者：
Zimmerman FJ
中科院分区：
文献类型：
--
作者：
Christakis DA;Van Cleve W;Zimmerman FJ
根据目前对学校中断与教育程度下降之间的关联以及教育程度下降与预期寿命下降之间的关联的理解，是否有可能估计2019年冠状病毒病大流行期间学校关闭与美国接受公立教育的小学学龄儿童预期寿命下降之间的关联？这个决策分析模型发现，2020年期间错过的指令可能与估计553万年的寿命损失有关。预期寿命的这种损失可能比如果小学不停课导致第一波大流行病的扩大所观察到的要大。这些研究结果表明，在2020年前几个月关闭美国公立小学的决定可能与美国儿童预期寿命的下降有关。该决策分析模型估计了2019年冠状病毒病大流行期间与学校关闭相关的美国小学学龄儿童的潜在寿命损失。美国小学于2020年2019冠状病毒病（COVID-19）大流行期间关闭，影响数百万儿童，对教育中断相关的潜在健康后果知之甚少。估计在小学关闭或继续开放的情况下，与COVID-19大流行相关的潜在寿命损失年数。该决策分析模型使用美国疾病控制和预防中心、美国社会保障局和美国人口普查局的2020年数据等公开数据源，对学校关闭与教育程度降低之间的关联以及教育程度降低与预期寿命之间的关联进行了估算。还估计了COVID-19的直接死亡率以及如果学校开放导致COVID-19传播增加可能导致的死亡率潜在增加。多年的生命损失。共有2420万名5至11岁的儿童就读于2020年大流行期间关闭的公立学校，损失了54天（四分位数范围，48-62.5）的教学时间。缺课与男孩最终教育成就的平均损失0.31年（95%可信区间[CI]，0.10-0.65）和女孩0.21年（95% CI，0.06-0.46）相关。在整个人口中，估计有553万（95% CI，1.88-10.80）YLL可能与学校关闭有关。截至2020年5月底，美国疾病控制和预防中心报告了总计88 241例COVID-19死亡病例，估计导致150万（95% CI，123 - 185万）YLL。如果学校继续开放，根据将学校关闭与减少流行病传播联系起来的研究结果，预计会增加147万（95%可信区间，0.45-2.59）年寿命。比较“学校开放”和“学校关闭”条件下估计的YLL的完整分布，分析发现，学校开放与学校关闭相比，总YLL较低的可能性为98.1%。在这个决定分析模型中，在不同的学校关闭条件下可能失去的生命年数，分析倾向于学校继续开放。今后关于在大流行期间关闭学校的决定应考虑到教育中断与预期寿命缩短之间的联系，并更加重视关闭学校对儿童健康的潜在后果。
Based on the current understanding of the associations between school disruption and decreased educational attainment and between decreased educational attainment and lower life expectancy, is it possible to estimate the association between school closure during the coronavirus disease 2019 pandemic and decreased life expectancy of publicly educated primary school–aged children in the United States? This decision analytical model found that missed instruction during 2020 could be associated with an estimated 5.53 million years of life lost. This loss in life expectancy was likely to be greater than would have been observed if leaving primary schools open had led to an expansion of the first wave of the pandemic. These findings suggest that the decision to close US public primary schools in the early months of 2020 may be associated with a decrease in life expectancy for US children. This decision analytical model estimates the potential years of life lost among US primary school–aged children associated with school closures during the coronavirus disease 2019 pandemic. United States primary school closures during the 2020 coronavirus disease 2019 (COVID-19) pandemic affected millions of children, with little understanding of the potential health outcomes associated with educational disruption. To estimate the potential years of life lost (YLL) associated with the COVID-19 pandemic conditioned on primary schools being closed or remaining open. This decision analytical model estimated the association between school closures and reduced educational attainment and the association between reduced educational attainment and life expectancy using publicly available data sources, including data for 2020 from the US Centers for Disease Control and Prevention, the US Social Security Administration, and the US Census Bureau. Direct COVID-19 mortality and potential increases in mortality that might have resulted if school opening led to increased transmission of COVID-19 were also estimated. Years of life lost. A total of 24.2 million children aged 5 to 11 years attended public schools that were closed during the 2020 pandemic, losing a median of 54 (interquartile range, 48-62.5) days of instruction. Missed instruction was associated with a mean loss of 0.31 (95% credible interval [CI], 0.10-0.65) years of final educational attainment for boys and 0.21 (95% CI, 0.06-0.46) years for girls. Summed across the population, an estimated 5.53 million (95% CI, 1.88-10.80) YLL may be associated with school closures. The Centers for Disease Control and Prevention reported a total of 88 241 US deaths from COVID-19 through the end of May 2020, with an estimated 1.50 million (95% CI, 1.23-1.85 million) YLL as a result. Had schools remained open, 1.47 million (95% credible interval, 0.45-2.59) additional YLL could have been expected as a result, based on results of studies associating school closure with decreased pandemic spread. Comparing the full distributions of estimated YLL under both “schools open” and “schools closed” conditions, the analysis observed a 98.1% probability that school opening would have been associated with a lower total YLL than school closure. In this decision analytical model of years of life potentially lost under differing conditions of school closure, the analysis favored schools remaining open. Future decisions regarding school closures during the pandemic should consider the association between educational disruption and decreased expected lifespan and give greater weight to the potential outcomes of school closure on children’s health.
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