Smoking and the widening inequality in life expectancy between metropolitan and nonmetropolitan areas of the United States.
Smoking and the widening inequality in life expectancy between metropolitan and nonmetropolitan areas of the United States.
复制标题
吸烟与美国大都市和非大都市地区之间预期寿命不平等的扩大。
DOI：
10.3389/fpubh.2022.942842
复制
发表时间：
2022
影响因子：
5.2
通讯作者：
Ho, Jessica Y.
中科院分区：
文献类型：
--
作者：
Hendi, Arun S.;Ho, Jessica Y.
在过去的25年里，美国死亡率的地理不平等迅速增加，特别是在大都市和非大都市地区之间。这些差距相当大，与美国和其他高收入国家之间的预期寿命差距不相上下。这项研究确定了吸烟的贡献，在美国过早死亡的一个关键因素，在过去的四分之一世纪世纪死亡率的地理不平等。我们使用的死亡证明和人口普查数据涵盖了1990年1月1日至2019年12月31日期间50岁以上的美国人口。我们将县分为40个地理区域，并按地区和大都市类别交叉分类。我们估计了1990-1992年和2017-2019年这些地区50岁时的预期寿命和死亡率差异指数，这是一种衡量死亡率不平等的指标。我们估计了这两个时期之间预期寿命水平的变化和吸烟导致的死亡率不平等的百分比变化。我们发现，城市居民和非城市居民之间的预期寿命的差距男性增加了2.17岁，女性增加了2.77岁。与吸烟有关的死亡人数的变化分别占这些增长的19%和22%。在40个地理区域中，男性因吸烟变化而增加的预期寿命从0.91年到2.34年不等，而女性因吸烟而减少的预期寿命从0.61年到0.45年不等。吸烟导致的寿命损失最有利的趋势往往集中在南部和中西部的大型中心城市，而最不利的趋势发生在这些地区的非城市。吸烟导致70岁以上男性的死亡率不平等增加，比例从8%到24%不等，50-84岁女性的比例从14%到44%不等。吸烟导致的死亡率在美国大城市和沿海地区下降最快，在非大城市地区下降较慢。死亡率的地域不平等日益加剧，部分原因是过去几十年来吸烟模式的地域差异。针对非大都市地区吸烟问题的政策可能会减少死亡率方面的地理不平等，并有助于提高未来的预期寿命。
Geographic inequality in US mortality has increased rapidly over the last 25 years, particularly between metropolitan and nonmetropolitan areas. These gaps are sizeable and rival life expectancy differences between the US and other high-income countries. This study determines the contribution of smoking, a key contributor to premature mortality in the US, to geographic inequality in mortality over the past quarter century. We used death certificate and census data covering the entire US population aged 50+ between Jan 1, 1990 and Dec 31, 2019. We categorized counties into 40 geographic areas cross-classified by region and metropolitan category. We estimated life expectancy at age 50 and the index of dissimilarity for mortality, a measure of inequality in mortality, with and without smoking for these areas in 1990–1992 and 2017–2019. We estimated the changes in life expectancy levels and percent change in inequality in mortality due to smoking between these periods. We find that the gap in life expectany between metros and nonmetros increased by 2.17 years for men and 2.77 years for women. Changes in smoking-related deaths are responsible for 19% and 22% of those increases, respectively. Among the 40 geographic areas, increases in life expectancy driven by changes in smoking ranged from 0.91 to 2.34 years for men while, for women, smoking-related changes ranged from a 0.61-year decline to a 0.45-year improvement. The most favorable trends in years of life lost to smoking tended to be concentrated in large central metros in the South and Midwest, while the least favorable trends occurred in nonmetros in these same regions. Smoking contributed to increases in mortality inequality for men aged 70+, with the contribution ranging from 8 to 24%, and for women aged 50–84, ranging from 14 to 44%. Mortality attributable to smoking is declining fastest in large cities and coastal areas and more slowly in nonmetropolitan areas of the US. Increasing geographic inequalities in mortality are partly due to these geographic divergences in smoking patterns over the past several decades. Policies addressing smoking in non-metropolitan areas may reduce geographic inequality in mortality and contribute to future gains in life expectancy.
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影响因子：
2.5
作者：
Elo, Irma T.;Hendi, Arun S.;Preston, Samuel H.
通讯作者：
Preston, Samuel H.
DOI：
10.1016/j.socscimed.2021.113712
发表时间：
2021-03
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Hendi AS;Elo IT;Martikainen P
通讯作者：
Martikainen P
DOI：
10.1111/j.1749-6632.2011.06202.x
发表时间：
2012-01-01
期刊：
ADDICTION REVIEWS
影响因子：
--
作者：
Hiscock, Rosemary;Bauld, Linda;Munafo, Marcus
通讯作者：
Munafo, Marcus
影响因子：
3.5
作者：
Hendi, Arun S.
通讯作者：
Hendi, Arun S.
影响因子：
7.7
作者：
Hendi, Arun S.
通讯作者：
Hendi, Arun S.