Changing contribution of area-level deprivation to total variance in age at death: a population-based decomposition analysis.
Changing contribution of area-level deprivation to total variance in age at death: a population-based decomposition analysis.
复制标题
地区层面的剥夺对死亡年龄总方差的影响的变化：基于人口的分解分析。
DOI：
10.1136/bmjopen-2018-024952
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发表时间：
2019
期刊：
影响因子：
2.9
通讯作者：
Caswell,Hal
中科院分区：
文献类型：
--
作者：
Seaman,Rosie;Riffe,Tim;Caswell,Hal
两个过程产生死亡年龄的总方差：异质性（组间方差）和个体随机性（组内方差）。有限的研究评估了这两个组成部分如何随着时间的推移而变化。我们量化了1981年至2011年期间苏格兰地区水平剥夺对死亡年龄总方差的贡献程度。设计获得了苏格兰的全部人口和死亡率数据，并与卡斯泰尔斯得分相匹配，这是一个标准化的z得分，用于测量相对地区水平剥夺的每个部分邮政编码部门。z分数高于零表明部分邮政编码部门的贫困程度高于全国平均水平。Z分数低于零表示较低的剥夺。从汇总的数据，我们构建了40个生命表，每个剥夺五分之一在1981年，1991年，2001年和2011年分层的sexy.Primary结局measurements总方差在死亡年龄和解释的比例由地区水平的剥夺异质性（组间方差）。最贫困地区的差异减少。就男性而言，最贫困的五分之一人口的预期寿命比最贫困的五分之一人口低7%至11%，标准差比最贫困的五分之一人口高6%至25%。这表明，剥夺对寿命SD的影响与其对预期寿命的影响相当。分解分析显示，从组间方差的贡献增加了一倍，1981年和2011年之间，但最多只解释4%的总variance.ConclusionsThis研究增加了新兴的机构的文献表明，社会经济群体经历了不同的趋势，在死亡年龄的方差。我们能够捕捉到的地区贫困对死亡年龄总差异的贡献自1981年以来翻了一番。地区一级的贫困可能在死亡率不平等方面发挥越来越重要的作用。
ObjectivesTwo processes generate total variance in age at death: heterogeneity (between-group variance) and individual stochasticity (within-group variance). Limited research has evaluated how these two components have changed over time. We quantify the degree to which area-level deprivation contributed to total variance in age at death in Scotland between 1981 and 2011.DesignFull population and mortality data for Scotland were obtained and matched with the Carstairs score, a standardised z-score calculated for each part-postcode sector that measures relative area-level deprivation. A z-score above zero indicates that the part-postcode sector experienced higher deprivation than the national average. A z-score below zero indicates lower deprivation. From the aggregated data we constructed 40 lifetables, one for each deprivation quintile in 1981, 1991, 2001 and 2011 stratified by sex.Primary outcome measuresTotal variance in age at death and the proportion explained by area-level deprivation heterogeneity (between-group variance).ResultsThe most deprived areas experienced stagnating or slightly increasing variance in age at death. The least deprived areas experienced decreasing variance. For males, the most deprived quintile life expectancy was between 7% and 11% lower and the SD is between 6% and 25% higher than the least deprived. This suggests that the effect of deprivation on the SD of longevity is comparable to its effect on life expectancy. Decomposition analysis revealed that contributions from between-group variance doubled between 1981 and 2011 but at most only explained 4% of total variance.ConclusionsThis study adds to the emerging body of literature demonstrating that socio-economic groups have experienced diverging trends in variance in age at death. The contribution from area-level deprivation to total variance in age at death, which we were able to capture, has doubled since 1981. Area-level deprivation may play an increasingly important role in mortality inequalities.