US childhood mortality, 1950 through 1993: Trends and socioeconomic diffferentials.
US childhood mortality, 1950 through 1993: Trends and socioeconomic diffferentials.
复制标题
1950 年至 1993 年美国儿童死亡率：趋势和社会经济差异。
DOI：
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发表时间：
1996
影响因子：
12.7
通讯作者：
S. Yu.
中科院分区：
文献类型：
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作者：
GK Singh;S. Yu.
目标
本研究根据性别、种族/民族、教育、家庭收入和死亡原因调查了1950年至1993年美国儿童死亡率的趋势和差异。
方法
对数线性，多元回归，和考克斯比例风险回归模型应用于国家生命统计系统，国家纵向死亡率研究和地区资源文件的数据。
结果
在过去的40年里，美国儿童死亡率大幅下降，主要是由于意外伤害、癌症、肺炎和流感以及先天性异常导致的死亡率下降。然而，自1968年以来，儿童自杀和杀人率增加了两倍至三倍，抑制了总体下降趋势。男性、黑人、美洲印第安人、夏威夷人和波多黎各儿童以及社会经济地位较低的儿童死亡风险增加。
结论
暴力、火器伤害和人类免疫缺陷病毒/获得性免疫缺陷综合征死亡率的上升趋势构成了美国儿童死亡率持续下降的主要障碍。减少社会经济差距和改善获得和利用保健的机会，可能会进一步降低总体儿童死亡率和与伤害有关的儿童死亡率。
OBJECTIVES
This study examined trends and differentials in US childhood mortality from 1950 through 1993 according to sex, race/ethnicity, education, family income, and cause of death.
METHODS
Log-linear, multiple regression, and Cox proportional hazards regression models were applied to the data from the National Vital Statistics System, the National Longitudinal Mortality Study, and the Area Resource File.
RESULTS
Substantial declines in US childhood mortality have occurred in the past 4 decades, primarily due to decreases in mortality from unintentional injuries, cancer, pneumonia and influenza, and congenital anomalies. The overall declining trend, however, has been dampened by a twofold to threefold increase in the suicide and homicide rates among children since 1968. Male, Black, American Indian, Hawaiian, and Puerto Rican children and those in the lower socioeconomic strata were at an increased risk of death.
CONCLUSIONS
Increasing trends in mortality from violence, firearm injuries, and human immunodeficiency virus/acquired immunodeficiency syndrome pose a major obstacle to continued declines in US childhood mortality. Reducing socioeconomic disparities and improving access to and use of health care may bring about further declines in overall and injury-related childhood mortality.