MORTALITY FROM CORONARY HEART-DISEASE IN ASIAN COMMUNITIES IN LONDON
MORTALITY FROM CORONARY HEART-DISEASE IN ASIAN COMMUNITIES IN LONDON
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DOI：
10.1136/bmj.297.6653.903
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发表时间：
1988-10-08
影响因子：
--
通讯作者：
MARMOT, MG
中科院分区：
文献类型：
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作者：
MCKEIGUE, PM;MARMOT, MG
方法和结果表的死亡的根本原因（国际疾病分类410-414与所有其他）和人口数字从1981年人口普查和调查办公室。出生在印度、巴基斯坦、孟加拉国和斯里兰卡的居民被归为亚洲人;出生在东非的布伦特和哈罗居民也被列入这一类别。每个自治市镇的亚洲人标准化死亡率是以该自治市镇的比率为标准计算的，为了便于直接比较，还使用了1981年英格兰和威尔士的比率（表）。标准化比例死亡率比较了冠心病在死亡证明上作为潜在原因的观察频率和预期频率;它们不依赖于人口普查数据，并且它们衡量了特定疾病的超额死亡率的程度。1979年至1983年出生国家的死亡率数据尚未公布，但除非我们研究的亚洲人口不具代表性，否则自1970年以来，英格兰和威尔士亚洲人的冠心病死亡率增加了约25%。在迁移中，选择对适应性的影响减弱，可能是这种增加的部分原因。伦敦亚裔人口的经济状况各不相同，从布伦特和哈罗的古吉拉特人的相对富裕到塔哈姆莱茨的孟加拉人的贫困。吸烟率从布伦特和哈罗3的古吉拉特妇女的非常低到塔哈姆莱茨的孟加拉国男子的很高。“布伦特和哈罗的大多数亚洲人都是素食主义者，而陶尔哈姆雷特和沃尔瑟姆森林的穆斯林社区通常不是。因此，令人惊讶的是，每个行政区的亚洲男性和女性冠心病死亡率比全国平均水平高出50%。对海外南亚人冠心病发病率高的任何一般性解释都必须援引构成英国亚裔人口的不同社区所共有的一些因素。
Methods and results Tables of deaths by underlying cause (International Classification of Disease 410-414 versus all other) and population figures from the 1981 census were obtained from the Office of Population Censuses and Surveys. Residents born in India, Pakistan, Bangladesh, and Sri Lanka were grouped as Asian; for Brent and Harrow residents born in east Africa were also included in this category. Standardised mortality ratios were calculated for Asians in each borough using the rates for that borough as the standard and also, to facilitate direct comparison, using the rates for England and Wales in 1981 (table). Standardised proportional mortality ratios compare the observed and expected frequencies with which coronary heart disease is given as the underlying cause on death certificates; they do not depend on census data, and they measure the extent to which excess mortality is specific to a particular disease. Ratios for Asian women in Tower Hamlets and Waltham Forest were based on only a few deaths.Comment National data for mortality by country of birth in 1979-83 are not yet available but, unless the Asian populations that we studied are unrepresentative, mortality from coronary heart disease among Asians in England and Wales has increased by about 25% since 1970-2. The diminished effects of selection for fitness at migration may account for some of this increase. The economic state of Asian populations in London varies from the comparative affluence of Gujaratis in Brent and Harrow to the deprivation experienced by Bangladeshis in Tower Hamlets. Smoking rates range from very low in Gujarati women in Brent and Harrow3 to high in Bangladeshi men in Tower Hamlets.'Most Asians in Brent and Harrow are vegetarian3 whereas the Moslem communities of Tower Hamlets and Waltham Forest are generally not. It is therefore striking that Asian men and women in each borough share a mortality from coronary heart disease 50% higher than the national average. Any general explanation of the high rates of coronary heart disease in south Asians overseas must invoke some factor that is common to the diverse communities that make up the Asian population in Britain.