The mortality divide in India: The differential contributions of gender, caste, and standard of living across the life course
The mortality divide in India: The differential contributions of gender, caste, and standard of living across the life course
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DOI：
10.2105/ajph.2004.060103
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发表时间：
2006-05-01
影响因子：
12.7
通讯作者：
Smith, GD
中科院分区：
文献类型：
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作者：
Subramanian, SV;Nandy, S;Smith, GD
目标.我们调查了性别、种姓和生活水平对印度人一生中死亡率不平等的影响。我们使用1998-1999年印度全国家庭健康调查数据对来自26个州的529321人进行了个体死亡率的多水平横断面分析。在所有年龄组中，生活水平最低和最高的五分位数之间观察到了显著的死亡率差异，范围从2至5岁年龄组的比值比（OR）4.61（95%置信区间[CI] =2.98，7.13）到45至64岁年龄组的OR 1.97（95% CI = 1.68，2.32）。女孩的超额死亡率仅在2至5岁年龄组中明显（OR = 1.33，95%CI = 1.13，1.58）。在生命的开始和结束阶段观察到了巨大的种姓差别。死亡率的地区差异部分是由于家庭生活水平和种姓的组成影响。在印度，整个生命过程中的死亡负担不成比例地福尔斯在经济弱势群体和低种姓群体身上。在死亡率的剩余国家一级的变化表明，在印度的死亡率鸿沟的潜在生态。
Objectives. We investigated the contributions of gender, caste, and standard of living to inequalities in mortality across the life course in India.Methods. We conducted a multilevel cross-sectional analysis of individual mortality, using the 1998-1999 Indian National Family Health Survey data for 529321 individuals from 26 states.Results. Substantial mortality differentials were observed between the lowest and highest standard-of-living quintiles across all age groups, ranging from an odds ratio (OR) of 4.61 (95% confidence interval [CI] =2.98, 7.13) in the age group 2 to 5 years to an OR of 1.97 (95% CI = 1.68, 2.32) in the age group 45 to 64 years. Excess mortality for girls was evident only for the age group 2 to 5 years (OR = 1.33, 95% CI = 1.13, 1.58). Substantial caste differentials were observed at the beginning and end stages of life. Area variation in mortality is partially a result of the compositional effects of household standard of living and caste.Conclusions. The mortality burden, across the life course in India, falls disproportionately on economically disadvantaged and lower-caste groups. Residual state-level variation in mortality suggests an underlying ecology to the mortality divide in India.