Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014.
Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014.
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DOI：
10.15585/mmwr.ss6601a1
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发表时间：
2017-01-13
期刊：
影响因子：
--
通讯作者：
Iademarco MF
中科院分区：
文献类型：
--
作者：
Moy E;Garcia MC;Bastian B;Rossen LM;Ingram DD;Faul M;Massetti GM;Thomas CC;Hong Y;Yoon PW;Iademarco MF
与大都市地区相比，非大都市地区（通常称为农村地区）的死亡率更高，但尚未进行系统评估。1999-2014年美国居民的死亡率数据来自国家生命统计系统，用于计算年龄调整后的死亡率以及非大都市和大都市地区五种主要死因的潜在超额死亡。调整后的死亡率包括所有年龄段，并通过直接法调整为2000年美国标准人口。潜在超额死亡被定义为年龄<80岁的人的死亡人数超过了如果死亡率最低的州的死亡率（即，基准状态）发生在所有国家。（基准州是2008-2010年期间每种原因发生率最低的三个州。对非大都市和大都市地区的潜在超额死亡分别进行了计算。数据来自美国和10个美国卫生与公众服务部公共卫生区域。在整个美国，非大都市地区的年龄调整死亡率高于大都市地区。非大城市地区80岁以下的人因五种主要原因造成的潜在超额死亡的百分比高于大城市地区。例如，在非大都市地区，约有一半的意外伤害和慢性下呼吸道疾病死亡是潜在的超额死亡，而在大都市地区，这一比例分别为39.2%和30.9%。公共卫生区域之间和内部的潜在超额死亡率也各不相同;在区域内，非大都市地区的潜在超额死亡率往往高于大都市地区。与大都市地区相比，非大都市地区的年龄调整死亡率更高，全国和公共卫生区域的五大主要死亡原因造成的潜在超额死亡百分比更高。对非大都市地区潜在的过度死亡进行常规跟踪可能有助于公共卫生部门识别新出现的健康问题，监测已知的问题，并集中干预措施，以减少这些地区可预防的死亡。
Higher rates of death in nonmetropolitan areas (often referred to as rural areas) compared with metropolitan areas have been described but not systematically assessed. 1999–2014 Mortality data for U.S. residents from the National Vital Statistics System were used to calculate age-adjusted death rates and potentially excess deaths for nonmetropolitan and metropolitan areas for the five leading causes of death. Age-adjusted death rates included all ages and were adjusted to the 2000 U.S. standard population by the direct method. Potentially excess deaths are defined as deaths among persons aged <80 years that exceed the numbers that would be expected if the death rates of states with the lowest rates (i.e., benchmark states) occurred across all states. (Benchmark states were the three states with the lowest rates for each cause during 2008–2010.) Potentially excess deaths were calculated separately for nonmetropolitan and metropolitan areas. Data are presented for the United States and the 10 U.S. Department of Health and Human Services public health regions. Across the United States, nonmetropolitan areas experienced higher age-adjusted death rates than metropolitan areas. The percentages of potentially excess deaths among persons aged <80 years from the five leading causes were higher in nonmetropolitan areas than in metropolitan areas. For example, approximately half of deaths from unintentional injury and chronic lower respiratory disease in nonmetropolitan areas were potentially excess deaths, compared with 39.2% and 30.9%, respectively, in metropolitan areas. Potentially excess deaths also differed among and within public health regions; within regions, nonmetropolitan areas tended to have higher percentages of potentially excess deaths than metropolitan areas. Compared with metropolitan areas, nonmetropolitan areas have higher age-adjusted death rates and greater percentages of potentially excess deaths from the five leading causes of death, nationally and across public health regions. Routine tracking of potentially excess deaths in nonmetropolitan areas might help public health departments identify emerging health problems, monitor known problems, and focus interventions to reduce preventable deaths in these areas.
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