Racial/Ethnic Differences in Mortality in Late Midlife: Have They Narrowed in Recent Years?
Racial/Ethnic Differences in Mortality in Late Midlife: Have They Narrowed in Recent Years?
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DOI：
10.1093/geronb/gbaa175
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发表时间：
2021-09-01
影响因子：
6.2
通讯作者：
Tarraf，Wassim
中科院分区：
文献类型：
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作者：
Doza，Adit;Jensen，Gail A.;Tarraf，Wassim
ObjectivesTo examine hazardous/ethnic differences in mortality rates have changed in recent years among adults in late midlife，and how.MethodsWe analyze Health and Retirement Study data on non-Hispanic Whites（Whites），non-Hispanic Blacks（Blacks），and English- and Spanish speaking Hispanics（西班牙裔-英语和西班牙裔-西班牙语），年龄50-64岁，来自2个阶段：1998-2004年（阶段1，n= 8，920）和2004-2010年（阶段2，n= 7，224）。使用调查广义线性回归技术，我们将期末死亡建模为种族/民族的函数，并顺序调整一系列特定时期的基线风险因素，包括人口统计学、健康状况、健康保险、健康行为和社交网络。回归分解技术被用来评估这些因素的贡献，观察到的种族/民族差异的死亡率rates.ResultsThe死亡的比值比（ORD）是没有统计学差异的黑人（与白人）在第1期，但在第2期高出33%（OR = 1.33; 95%置信区间[CI] = 1.05-1.69）。在这两个时期，西班牙裔英语（与白人）之间的调整后的ORD没有统计学差异。在第1阶段，西班牙裔-西班牙人（与白人相比）的校正ORD较低（ORD = 0.36; 95% CI = 0.22-0.59），但在第2阶段无法区分。在第1阶段，黑人死亡率差异的50.1%由基线健康状况解释，53.1%由经济因素解释。在第2阶段，55.8%的死亡率的差异是由健康状况，40.0%的财务因素，和16.2%的健康保险status.DiscussionMortality率之间的黑人和西班牙裔西班牙人自20世纪90年代中期上升。西班牙裔西班牙人可能正在失去他们长期以来被称为“西班牙裔Paradise”的优势较低的死亡率风险。
ObjectivesTo examine whether racial/ethnic differences in mortality rates have changed in recent years among adults in late midlife, and if so, how.MethodsWe analyze Health and Retirement Study data on non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks), and English- and Spanish-speaking Hispanics (Hispanic-English and Hispanic-Spanish), aged 50–64 from 2 periods: 1998–2004 (Period 1,n= 8,920) and 2004–2010 (Period 2,n= 7,224). Using survey-generalized linear regression techniques, we model death-by-end-of-period as a function of race/ethnicity and sequentially adjust for a series of period-specific baseline risk factors including demographics, health status, health insurance, health behaviors, and social networks. Regression decomposition techniques are used to assess the contribution of these factors to observed racial/ethnic differences in mortality rates.ResultsThe odds ratio for death (ORD) was not statistically different for Blacks (vs. Whites) in Period 1 but was 33% higher in Period 2 (OR = 1.33; 95% confidence interval [CI] = 1.05–1.69). The adjusted ORD among Hispanic-English (vs. Whites) was not statistically different in both periods. The adjusted ORD among Hispanic-Spanish (vs. Whites) was lower (ORD = 0.36; 95% CI = 0.22–0.59) in Period 1 but indistinguishable in Period 2. In Period 1, 50.1% of the disparity in mortality rates among Blacks was explained by baseline health status, 53.1% was explained by financial factors. In Period 2, 55.8% of the disparity in mortality rates was explained by health status, 40.0% by financial factors, and 16.2% by health insurance status.DiscussionMortality rates among Blacks and Hispanic-Spanish have risen since the mid-1990s. Hispanic-Spanish may be losing their advantageous lower risk of mortality, long known as the “Hispanic Paradox.”