中国婴儿死亡率和期望寿命的地区差异性研究

目的:以我国(大陆地区)各省市的婴儿死亡率和期望寿命为分析指标,以收敛性模型为分析工具,分析地区差异性的收敛特征。方法 :采用σ收敛(研究对象的标准差随时间逐步变小)和β收敛(发展初始水平较低的经济体比初始水平较高的经济体有更高的增长率)模型进行分析。结果 :婴儿死亡率显示了σ收敛趋势,而期望寿命的σ收敛变化则显示了不同时间分段内收敛趋势情况不同的现象,两个指标皆呈现β收敛,表明了我国婴儿死亡率和期望寿命地区差异性逐步缩小。结论 :建议长期观测各项卫生服务指标在全国各地的开展情况,考察变化趋势,促进人群健康的地区公平性。     

Closing the Gaps: competing estimates of Indigenous Australian life expectancy in the scientific literature

Objective: Closing the gap in life expectancy between Indigenous and other Australians within a generation is central to national Indigenous reform policy (Closing the Gap). Over time, various methods of estimating Indigenous life expectancy and with that, the life expectancy gap, have been adopted with differing, albeit non‐comparable results. We present data on the extent of the gap and elucidate the pattern of use and interpretations of the different estimates of the gap, between 2007 and 2012. Methods: An extensive search was conducted for all peer‐reviewed health publications citing estimates of and/or discussing the life expectancy of Indigenous Australians, for the period 2007–2012. Results: Five predominant patterns of citation of the gap estimates were identified: 20 years, 17 years, 15–20 years, 13 years, and 11.5 years for males and 9.7 years for females. Some authors misinterpret the most recent estimates as reflecting improvement from the 17‐year figure, rather than the result of different methods of estimation. Support for the direct methods used to calculate Indigenous life expectancy is indicated. Conclusions and Implications: A specific estimate of the life expectancy gap has not been established among stakeholders in Indigenous health. Agreement on the magnitude of the gap is arguably needed in order to evaluate strategies aimed at improving health outcomes for Indigenous Australians. Moreover, measuring progress towards ‘closing the gap’ depends on the availability of comparable estimates, using the same techniques of measurement to assess changes over time.     

Northern Territory indigenous life expectancy improvements, 1967-2004

OBJECTIVE: To assess the extent of changes in life expectancy at birth for the Indigenous population of the Northern Territory (NT) over the period 1967-2004, and to determine which age-specific mortality rates were mostly responsible for such change. METHODS: Life expectancy at birth figures were obtained via life table calculations using a high-quality and internally consistent dataset of NT Indigenous deaths and populations covering the period 1967-2004. A life expectancy at birth age decomposition technique was then applied. RESULTS: Indigenous life expectancy at birth has risen considerably in the NT, increasing from about 52 years for males and 54 years females in the late 1960s to about 60 years for males and 68 years for females in recent years. Significantly, for NT Indigenous females the gap with total Australian life expectancy has narrowed. CONCLUSIONS: In contrast to popular perception, Indigenous life expectancy in the Northern Territory has improved substantially from the late 1960s to the present. IMPLICATIONS: The widespread pessimism that surrounds Indigenous health and mortality is largely unfounded, at least for the NT. Although much remains to be done to reduce Indigenous mortality, the results in this paper demonstrate that improvements are occurring and that sustained and increased effort is worthwhile and will succeed.     

中国大陆地区健康期望寿命研究现状调查

目的 通过对中国大陆地区已发表的健康期望寿命文献进行计量分析,了解国内健康期望寿命研究现况,为国家卫生行政部门制定相关政策提供参考。方法 采用文献计量法对纳入文献从时间、地区、类型、健康期望寿命研究结果等方面进行描述性统计分析。结果 51篇已发表的文献中,2016年发表文献最多,占比17.6%。从地区上看,全国性研究最多,占比23.5%,其次为东部沿海地区,占比43.1%;直辖市发表文献较多于一般省份。从研究的人群看,60岁以上老年人的自评自理健康期望寿命研究相对较多,占比54.9%。从健康期望寿命的计算结果上看,大部分研究女性健康期望寿命高于男性。结论 中国大陆地区健康期望寿命研究处于初步阶段,对老年人群健康较为重视,且存在区域差异,经济较发达的东部地区,尤其是直辖市开展的研究较多。不同研究间的可比性较差,需建立统一的计算方法,增强不同地区间的可比性,以及同一地区不同年份的纵向可比性。     

Trends in infant and child mortality in Mozambique during and after a period of conflict

This study describes urban and rural trends of infant, child and under-five mortality in Mozambique (1973-1997) by mother's place of residence. A direct method of estimation was applied to the 1997 Mozambican Demographic and Health Survey data. The levels of infant, child and under-five mortality were considerably higher in rural than in urban areas. The difference in mortality between urban and rural areas increased over time until 1988-1992 and thereafter diminished. Possible causes of the different trends (e.g. the impact of civil war, drought, migration, adjustment programme and HIV/AIDS) are discussed. The increase in mortality in urban areas during the last few years before the survey may have been related to the immigration to urban areas of mothers whose children had high levels of mortality. Higher levels of infant, child and under-five mortality still prevail, particularly in rural areas. Further studies are needed to investigate the differentials of infant and child mortality by mother's place of residence.     

1990-2015年中国分省期望寿命和健康期望寿命分析

目的 分析中国及各省期望寿命和健康期望寿命现状及其变化情况。方法 利用2015年全球疾病负担研究结果,对2015年中国居民与全球主要国家期望寿命和健康期望寿命进行比较;分析全国及各省期望寿命和健康期望寿命的差异和1990-2015年全国及各省期望寿命和健康期望寿命的变化幅度。结果 2015年中国居民的期望寿命为76.2岁,健康期望寿命为68.0岁,分别比全球平均水平高出4.4岁和5.2岁。2015年中国人均期望寿命和健康期望寿命,女性均高于男性。我国期望寿命和健康期望寿命较高的省份有上海、北京、香港、澳门、浙江、江苏、天津和广东等东部发达省份,较低的省份有西藏、青海、贵州、新疆和云南等西部省份。1990-2015年,中国居民期望寿命和健康期望寿命均呈上升趋势,期望寿命增加了9.5岁,健康期望寿命增加了8.4岁。全国及各省期望寿命增加的岁数均高于健康期望寿命增加的岁数。结论 1990-2015年中国居民的期望寿命和健康期望寿命有了较大程度的提高,但各省之间差异较大。     

2008-2018年中国4省重点地区肝癌死亡趋势及去死因期望寿命分析

目的分析2008-2018年中国4省重点地区人群肝癌死亡率变化趋势, 探讨肝癌死亡对期望寿命变化的影响程度, 为评估该地区综合防控效果、促进卫生资源合理配置提供数据支撑。方法基于2008-2018年中国CDC全国死因监测数据库中4省重点地区死因数据, 分析该地区肝癌死亡率、去死因期望寿命(CELE)、去死因期望寿命增长年(PGLEs), 采用Joinpoint 4.9.0.0软件计算平均年度变化百分比(AAPC), 采用Arriaga分解法估计各年龄组肝癌死亡率变化对期望寿命变化的贡献情况。结果 2008-2018年4省重点地区肝癌标化死亡率整体呈下降趋势(AAPC=-4.37%, P<0.001)。肝癌死亡率变化对期望寿命增长起积极作用, 贡献值0.240岁, 贡献度5.62%;其中, 积极作用最大的是45～49岁年龄组(0.041岁, 0.96%), 消极作用最大的是50～54岁年龄组(-0.015岁, -0.35%)。与2008年相比, 2018年4省重点地区人群期望寿命增长4.27岁(AAPC=0.59%, P<0.001), 肝癌CELE增长4.20岁(AAPC=...     

Dementia-free life expectancy (DemFLE) in The Netherlands

To gain an insight into the burden of dementia in an aging society, life expectancy with dementia and its counterpart dementia-free life expectancy (DemFLE) in The Netherlands are presented. Sullivan's method was used to calculate DemFLE. For elderly living either independently or in homes for the elderly prevalence figures on dementia were obtained from the Rotterdam Elderly Study (RES; n = 7528); for elderly in nursing homes the SIG Nursing home Information System was used. Conforming to other authors only the prevalence data on moderate and severe dementia as diagnosed with DSM-III-R criteria are used. The prevalence of mild dementia was not taken into account. At 65 years DemFLE for men is 14.0 years, that is 96.4% of the total life expectancy (14.5 years at this age). At age 90, DemFLE for men is 2.5 years, equal to 77.5% of the total life expectancy (3.3 years). For women DemFLE at age 65 is 17.7 years, that is 93.2% of their life expectancy (19.0 years), and at the age of 90, DemFLE for women is 2.8 years, equal to 74.7% of their remaining life expectancy (3.8 years). The absolute number of years with dementia remains relatively constant with increasing age. About 20–25% of these years with dementia are spent in nursing homes, the other 75–80% living independently. At each age compared with men women have both a higher DemFLE and a higher expectancy of years with dementia. The percentage of life expectancy without dementia however, is always lower for women, because of their higher total life expectancy. This indicates that the burden of dementia in absolute and relative terms is higher for women. Most years with dementia are spent at home, indicating that the burden of dementia rests mainly on the shoulders of informal caregivers.     

上海市居民期望寿命与健康期望寿命的差异分析

目的:分析不同年龄、性别的上海市居民期望寿命和健康期望寿命的差异。方法:分析比较上海市和全球长寿国家/地区期望寿命的变化趋势;利用全球疾病负担研究建立的疾病和健康结局的失能权重,应用Sullivan法测算上海市居民健康期望寿命,并分析不同年龄、性别人群的健康寿命损失。结果:近40年,上海市期望寿命增长了10.86岁,2...     

中国流动老人的健康期望寿命研究

目的 了解流动老人的健康期望寿命,包括自评健康期望寿命和生活自理期望寿命, 并探索其影响因素。方法 利用2015年流动人口动态监测调查中的老年人数据,采用Sullivan法分析流动老人的自评健康期望寿命和生活自理期望寿命,logistic回归分析其影响因素。结果 60～64岁流动老人的自评健康期望寿命约为17.7岁,生活自理期望寿命约为20.6岁。女性的健康期望寿命比男性高,但是健康期望寿命损失率也比男性高。慢性病会对老年人的健康产生重要的负面影响, 家庭收入高、教育水平高、流动范围大、参加健康体检、有伴侣、本地朋友多、锻炼时间长都是流动老人健康的保护因素。结论 流动老人健康状况整体较好,相关部门需要提升流动老人卫生服务的利用率,加强对流动老人的慢病管理,鼓励老年人养成健康的生活方式。对高龄女性、社会经济地位低、无伴侣、少数民族的流动老人应给予重点关注。     

2005-2018年中国分省死亡率及期望寿命分析

目的:掌握2005-2018年全国及分省死亡率及期望寿命现状分布及变化情况。方法:利用全国人口死亡信息登记管理系统死因监测数据、全国妇幼卫生监测数据、全国死因监测漏报调查数据及社会决定因素相关协变量数据,对2005-2018年全国及分省居民死亡率及期望寿命进行估计,描述全国及分省死亡率和期望寿命差异及变化趋势。采用死亡...     

中国健康预期寿命指标体系构建

健康预期寿命(HLE)研究是老龄化社会和健康中国建设需求, 但我国尚未制定具体政策目标值, 也未官方公布过HLE。需建立HLE指标体系, 指导HLE测算和研究。根据WHO对健康的定义, 融入联合国可持续发展目标、全健康和主动健康理念, 在梳理国际现有HLE指标体系基础上, 基于WHO的国际功能、残疾和健康分类和国际疾病分类框架, 提出了多维度HLE指标体系概念框架和指标结构。概念框架包括基本的身体、心理、行为、社会和环境健康5个维度, 同时增加测量残障程度的综合指标失能指数。以此为基础, 提出HLE主要健康测量指标的框架, 包括行为因素、生理和病理原因、残障、功能受限、失能和死亡, 并进一步讨论了HLE指标体系的构建思路、数据类型和来源。本文有助于促进HLE研究和实践, 助力老龄化应对和健康中国建设。     

浙江省居民健康期望寿命分析

目的 分析浙江省居民1998、2003和2008年健康期望寿命以及年龄、性别和城乡之间的差异.方法 利用浙江省死因监测资料和浙江省卫生服务调查家庭户成员相关健康资料,采用Sullivan法计算健康期望寿命.结果 浙江省居民期望寿命、健康期望寿命和健康期望寿命比值,1998年为73.89岁、58.09岁和78.62%,2003年为75.91岁、57.76岁和76.08%,2008年为76.70岁、59.57岁和77.66%.浙江省居民期望寿命、健康期望寿命和健康期望寿命比值均随着年龄的上升而下降.女性期望寿命高于男性,男性健康期望寿命比值高于女性.城市居民期望寿命高于农村居民,但是农村居民健康期望寿命和健康期望寿命比值均高于城市居民.结论 浙江省居民期望寿命随着年份递增而递增,不同年龄、不同性别和不同地区的健康期望寿命存在差异,应采取不同卫生政策.     

中国的死亡率进度效应与去进度效应平均预期寿命

目的：介绍死亡率进度效应，其也是高估中国人口平均预期寿命的不可忽略的因素之一，说明去进度效应平均预期寿命是衡量人口寿命水平和健康水平变动趋势的更佳指标。方法：采用1994-2016年中国的死亡数据，以John Bongaarts和Griffith Feeney提出的三步估计策略，考察了中国的去进度效应平均预期寿命。结果与结论：（1）与常规预期寿命指标相比，去进度效应平均预期寿命呈更加平稳增长的趋势，女性的平均预期寿命及其增长速度均高于男性；（2）中国1994-2016年平均预期寿命的进度效应在2~5岁之间波动，平均在2.5岁以上，明显高于已有研究所涉及欧美国家的进度效应，表明中国死亡率下降速度更快；（3）就"六普"而言，进度效应会造成常规平均预期寿命高估寿命水平，男性、女性和两性合计人口的幅度分别为2.43岁、2.63岁和2.57岁，去进度效应预期寿命或许可以更好地测度中国人口的寿命水平及其变化趋势。     

2014年遵义市居民期望寿命和去死因期望寿命分析

目的 分析遵义市居民期望寿命,了解主要死因对遵义市居民期望寿命的影响,为制定疾病预防和控制策略提供科学依据。方法 收集2014年遵义市死因监测点数据和漏报数据,运用简略寿命表和去死因简略寿命表,计算期望寿命、去死因期望寿命、寿命损失年数和损失率等指标。结果 2014年遵义市死因监测点居民期望寿命为75.76岁,男性和女性依次为73.41岁和78.43岁,女性期望寿命比男性高5.02岁。去除循环系统疾病、肿瘤、呼吸系统疾病、损伤与中毒、消化系统疾病前5位死因后,人均期望寿命可依次增加6.66、2.03、1.97、1.35和0.40岁,男性期望寿命增幅与全人群一致,女性期望寿命顺位与全人群略有差别,呼吸系统疾病居第2位。去除脑血管病、心脏病、恶性肿瘤和慢性下呼吸道疾病后,期望寿命分别增长2.80岁、2.31岁、0.92岁、0.87岁。结论 遵义市居民期望寿命值有待进一步提高,重点应加强心脑血管疾病、恶性肿瘤以及慢性下呼吸道疾病等慢性非传染性疾病的防治工作。     

2013年中国居民预期寿命和去死因预期寿命分析

目的 系统分析2013年我国不同地区、不同人群预期寿命及主要疾病对预期寿命的影响程度,揭示我国经济和社会发展对居民健康水平及公平性提高的影响和作用。方法 综合利用国家统计局人口普查及国家卫生和计划生育委员会人口死亡登记数据,采用指数模型、漏报调整及简略寿命表等方法,系统估算我国居民2013年人均预期寿命水平及疾病影响程度。结果 2013年我国居民预期寿命为75.8岁,较2010年的74.8岁提高约1岁。其中城市约为77.4岁,农村约为75.1岁,城乡差距约为2.3岁;东部地区约为77.2岁,中部地区约为75.8岁,西部地区约为73.5岁,东西地区差距约为3.6岁。2013年造成我国居民预期寿命损失的前10位疾病分别为脑血管病,缺血性心脏病,慢性阻塞性肺病,肺、气管和支气管癌,道路伤害,肝癌,胃癌,高血压心脏病,下呼吸道感染,食道癌,共造成寿命损失7.97岁。结论 我国居民预期寿命已处于较高水平,地区间差异依然存在,应制定针对不同地区的疾病管理、医疗救治及危险因素干预政策,使预期寿命进一步提高,并提高生存质量。     

上海市成年人健康期望寿命测算研究

目的:评价上海市居民健康状况,测算健康期望寿命,分析影响居民健康相关因素,为卫生决策提供有力的信息和依据。方法:采用多阶段分层随机抽样方法随机抽取上海市≥18岁户籍居民作为调查对象,采用WHO在世界健康调查中使用的自评健康调查问卷,进行居民自评健康状况调查。应用CHOHT模型校正自评健康调查数据,获得人群自报伤残测度,...     

Rising mortality and life expectancy differentials by lifetime earnings in the United States

Are mortality and life expectancy differences by socioeconomic groups increasing in the United States? Using a unique data set matching administrative and survey data, this study explores trends in these differentials by lifetime earnings for the 1983–2003 period. Results indicate a consistent increase in mortality differentials across sex and age groups. The study also finds a substantial increase in life expectancy differentials by lifetime earnings: the top-to-bottom quintile premium increased 30 percent for men and almost doubled for women. These results complement recent research to point to almost five decades of increasing differential mortality in the United States.     

Trends in the Mexican infant mortality paradox over the past two decades

PurposeMexicans in the United States have lower rates of several important population health metrics than non-Hispanic whites, including infant mortality. This mortality advantage is particularly pronounced among infants born to foreign-born Mexican mothers. However, the literature to date has been relegated to point-in-time studies that preclude a dynamic understanding of ethnic and nativity differences in infant mortality among Mexicans and non-Hispanic whites.MethodsWe assessed secular trends in the relation between Mexican ethnicity, maternal nativity, and infant mortality between 1989 and 2006 using a linked birth–death data set from one US state.ResultsCongruent to previous research, we found a significant mortality advantage among infants of Mexican relative to non-Hispanic white mothers between 1989 and 1991 after adjustment for baseline demographic differences (relative risk = 0.78, 95% confidence interval, 0.62–0.98). However, because of an upward trend in infant mortality among infants of Mexican mothers, the risk of infant mortality was not significantly different from non-Hispanic white mothers in later periods.ConclusionsOur findings suggest that the “Mexican paradox” with respect to infant mortality is resolving. Changing sociocultural norms among Mexican mothers and changes in immigrant selection and immigration processes may explain these observations, suggesting directions for future research.     

Risk factors and child mortality among the Miao in Yunnan, Southwest China

Environmental factors and the lifestyle of communities in developing countries as in the industrialized world have a great deal to do with their health status. This study carried out among the Miao people of southeastern Yunnan province in Southwest China has demonstrated important links between child mortality (one indicator of health status) and specific risk factors. These include lifestyle variables such as geographic mobility, the age of weaning and religious belief. In addition, the use of available health care facilities was another explanatory variable. Perhaps surprisingly, a history of tuberculosis seemed also to be empirically related to the presence or absence of child mortality. Although it was impossible to show a significant statistical relationship between traditional practices and child mortality from the study's database, the authors have observed qualitatively that birthing customs play an important role in explaining the perinatal component of child mortality. These various relationships shed some light on potential areas for intervention with a view to reducing the levels of child mortality among minority peoples in China and elsewhere.