Falling behind: life expectancy in US counties from 2000 to 2007 in an international context.
Falling behind: life expectancy in US counties from 2000 to 2007 in an international context.
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DOI：
10.1186/1478-7954-9-16
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发表时间：
2011-06-15
影响因子：
3.3
通讯作者：
Murray CJ
中科院分区：
文献类型：
--
作者：
Kulkarni SC;Levin-Rector A;Ezzati M;Murray CJ
美国的医疗保健辩论集中在该国相对于其他高收入国家而言缺乏保险和健康状况不佳的独特高比率上。在美国，健康结果的巨大差异是有据可查的，但最近对死亡率的县差异的评估是从1999年开始的。跟踪卫生改革立法的进展至关重要，以便对各县之间的预期寿命差异进行最新评估。美国的差距可以在每个国家的进展与国际趋势相比的背景下更清楚地看到。我们使用2000年至2007年美国按年龄、性别和县划分的新发布的死亡率数据，分别计算每个性别、所有种族、白人和黑人的生命表。我们提出，验证，并应用新的方法来估计最近的生命表的小区域，以产生最新的估计。将各县的预期寿命率和预期寿命变化与2000年和2007年各国的预期寿命进行比较。我们计算了每个国家在2000年和2007年落后于国际预期寿命时间序列的日历年数。在美国各县，2007年男性预期寿命为65.9至81.1岁，女性为73.5至86.0岁。与死亡率最低的10个国家的预期寿命时间序列相比，美国各县的男性预期寿命从提前15个日历年到落后50个日历年，女性预期寿命从提前16个日历年到落后50个日历年。黑人男子的县预期寿命从59.4岁到77.2岁不等，落后于国际边界的县从7年到50多年不等;黑人妇女的预期寿命从69.6岁到82.6岁不等，落后于国际边界的县从8年到50多年不等。在2000年至2007年期间，80%（男性）和91%（女性）的美国县与国际预期寿命标准相比有所下降。美国有着极大的地理和种族差异，一些社区的预期寿命已经远远落后于表现最好的国家。与此同时，大多数社区的相对业绩继续下降。解决这些问题的努力需要解决主要的可预防死亡原因。
The United States health care debate has focused on the nation's uniquely high rates of lack of insurance and poor health outcomes relative to other high-income countries. Large disparities in health outcomes are well-documented in the US, but the most recent assessment of county disparities in mortality is from 1999. It is critical to tracking progress of health reform legislation to have an up-to-date assessment of disparities in life expectancy across counties. US disparities can be seen more clearly in the context of how progress in each county compares to international trends. We use newly released mortality data by age, sex, and county for the US from 2000 to 2007 to compute life tables separately for each sex, for all races combined, for whites, and for blacks. We propose, validate, and apply novel methods to estimate recent life tables for small areas to generate up-to-date estimates. Life expectancy rates and changes in life expectancy for counties are compared to the life expectancies across nations in 2000 and 2007. We calculate the number of calendar years behind each county is in 2000 and 2007 compared to an international life expectancy time series. Across US counties, life expectancy in 2007 ranged from 65.9 to 81.1 years for men and 73.5 to 86.0 years for women. When compared against a time series of life expectancy in the 10 nations with the lowest mortality, US counties range from being 15 calendar years ahead to over 50 calendar years behind for men and 16 calendar years ahead to over 50 calendar years behind for women. County life expectancy for black men ranges from 59.4 to 77.2 years, with counties ranging from seven to over 50 calendar years behind the international frontier; for black women, the range is 69.6 to 82.6 years, with counties ranging from eight to over 50 calendar years behind. Between 2000 and 2007, 80% (men) and 91% (women) of American counties fell in standing against this international life expectancy standard. The US has extremely large geographic and racial disparities, with some communities having life expectancies already well behind those of the best-performing nations. At the same time, relative performance for most communities continues to drop. Efforts to address these issues will need to tackle the leading preventable causes of death.
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影响因子：
15.8
作者：
Murray CJ;Kulkarni SC;Michaud C;Tomijima N;Bulzacchelli MT;Iandiorio TJ;Ezzati M
通讯作者：
Ezzati M
影响因子：
5
作者：
FELDMAN, JJ;MAKUC, DM;CORNONIHUNTLEY, J
通讯作者：
CORNONIHUNTLEY, J
影响因子：
3.3
作者：
Danaei G;Friedman AB;Oza S;Murray CJ;Ezzati M
通讯作者：
Ezzati M
影响因子：
37.8
作者：
Ezzati, Majid;Oza, Shefali;Murray, Christopher J. L.
通讯作者：
Murray, Christopher J. L.
影响因子：
15.8
作者：
Krieger, Nancy;Rehkopf, David H.;Kennedy, Malinda
通讯作者：
Kennedy, Malinda