Excess Mortality in California by Education During the COVID-19 Pandemic.
Excess Mortality in California by Education During the COVID-19 Pandemic.
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DOI：
10.1016/j.amepre.2022.06.020
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发表时间：
2022-11
影响因子：
5.5
通讯作者：
Glymour, M. Maria
中科院分区：
文献类型：
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作者：
Chen, Yea-Hung;Matthay, Ellicott C.;Chen, Ruijia;DeVost, Michelle A.;Duchowny, Kate A.;Riley, Alicia R.;Bibbins-Domingo, Kirsten;Glymour, M. Maria
了解2019冠状病毒病（COVID-19）大流行期间死亡率过高的教育模式可能有助于确定减少差异的策略。目前尚不清楚COVID-19死亡率中的教育不平等是否在整个大流行期间持续存在，是否跨越了所有教育程度，或是否因COVID-19风险的其他人口统计指标（如年龄或职业）而有所不同。这项研究分析了加州公共卫生部2016年1月至2021年2月期间年龄≥25岁的个人（1，502，202例死亡）的死亡数据。作者将ARIMA（自回归综合移动平均）模型应用于由最高教育水平和其他人口统计数据（年龄，性别，种族/民族，美国出生，职业部门和城市化）定义的亚组。作者估计了超额死亡人数（观察到的死亡人数减去在没有大流行的反事实下预计发生的死亡人数）和每10万人的超额死亡人数。教育方面的不平等导致死亡率过高，这种现象在大流行病早期就出现了，并在第一年持续存在。最大的人均过剩发生在没有高中文凭的人群中（每10万人中多死亡533人），其次是有高中文凭但没有大学文凭的人（466/100，000），一些大学（156/100，000）和学士学位（120/100，000），研究生/专业学位人群中最低（101/100，000）。教育不平等现象发生在每一个分组审查。例如，没有大学经历的拉丁美洲人的人均超额死亡率是至少有一些大学经历的拉丁美洲人的3.7倍。在大流行期间，教育不平等普遍导致死亡率过高，这表明有多个潜在的干预点可以减少差异。
Understanding educational patterns in excess mortality during the coronavirus disease 2019 (COVID-19) pandemic may help to identify strategies to reduce disparities. It is unclear whether educational inequalities in COVID-19 mortality have persisted throughout the pandemic, spanned the full range of educational attainment, or varied by other demographic indicators of COVID-19 risks, such as age or occupation. This study analyzed individual-level California Department of Public Health data on deaths occurring between January 2016 and February 2021 among individuals aged ≥25 years (1,502,202 deaths). Authors applied ARIMA (autoregressive integrated moving average) models to subgroups defined by the highest level of education and other demographics (age, sex, race/ethnicity, U.S. nativity, occupational sector, and urbanicity). Authors estimated excess deaths (the number of observed deaths minus the number of deaths expected to occur under the counterfactual of no pandemic) and excess deaths per 100,000 individuals. Educational inequalities in excess mortality emerged early in the pandemic and persisted throughout the first year. The greatest per-capita excess occurred among people without high-school diplomas (533 excess deaths/100,000), followed by those with a high-school diploma but no college (466/100,000), some college (156/100,000), and bachelor's degrees (120/100,000), and smallest among people with graduate/professional degrees (101/100,000). Educational inequalities occurred within every subgroup examined. For example, per-capita excess mortality among Latinos with no college experience was 3.7 times higher than among Latinos with at least some college experience. Pervasive educational inequalities in excess mortality during the pandemic suggest multiple potential intervention points to reduce disparities.
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作者：
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通讯作者：
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影响因子：
3.7
作者：
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DOI：
10.1164/rccm.202007-2794oc
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影响因子：
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影响因子：
6.3
作者：
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通讯作者：
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影响因子：
8.5
作者：
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通讯作者：
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