Vaca Federico, Anderson Craig L
University of California, Irvine School of Medicine, Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, USA.
Ann Adv Automot Med. 2009 Oct;53:77-82.
The Latino Epidemiologic Paradox describes favorable health profiles for Latinos compared to non-Latino Whites (NLW) despite poverty, low education, and low access to health care. An anomaly to this paradox is increased mortality of Latino adolescent and emerging adult males. Previous research shows motor vehicle crash fatalities bear a considerable proportion of the mortality burden attributed to this anomaly. Utilizing two U.S. data sources (CDC-WISQARS and NHTSA-FARS), graphical and linear regression methods were used to analyze crash fatality trends and changes in factors that influence crash injury fatality among young Latino males age 15-24. During 1999-2006, 59,719 motor vehicle fatalities occurred among Latino, NLW and Non-Latino Black (NLB) young males. Fatality rates were 37.7, 39.6, and 29.8 per 100,000 population/year for Latinos, NLW and NLB respectively. Over the study period, young Latino male mortality rates increased 27%. By 2006, fatality rates were 41.9, 38.3 and 27.8 per 100,000 population/year for Latinos, NLW and NLB respectively. Among driver fatalities, 43% Latino, 33% NLW and 27% NLB were restrained. Fifty-seven percent of Latino drivers had blood alcohol >or=0.01 g/dl (BAC+), as did 47% of NLW drivers and 42% of NLB drivers. Over the study period, BAC+ changed little among Latinos and NLW drivers but decreased among NLB drivers. Motor vehicle fatality rates for young Latino males are rising despite increasing restraint use and leveling driver BAC+. Without racial/ethnic specific exposure data, limitations exist in discerning the cause of diverging fatality trends and further understanding specific racial/ethnic group crash fatality disparities.
拉丁裔流行病学悖论描述了尽管拉丁裔面临贫困、教育程度低和医疗保健可及性差等问题,但与非拉丁裔白人(NLW)相比,他们却有着良好的健康状况。这一悖论的一个反常现象是拉丁裔青少年和刚成年男性的死亡率上升。先前的研究表明,机动车碰撞致死在这一反常现象所导致的死亡负担中占相当大的比例。利用两个美国数据源(疾病控制与预防中心的WISQARS和美国国家公路交通安全管理局的FARS),采用图形和线性回归方法分析了15至24岁年轻拉丁裔男性的碰撞致死趋势以及影响碰撞致伤死亡的因素变化。在1999年至2006年期间,拉丁裔、非拉丁裔白人和非拉丁裔黑人(NLB)的年轻男性中发生了59719起机动车死亡事故。拉丁裔、非拉丁裔白人和非拉丁裔黑人的死亡率分别为每10万人口/年37.7、39.6和29.8例。在研究期间,年轻拉丁裔男性的死亡率上升了27%。到2006年,拉丁裔、非拉丁裔白人和非拉丁裔黑人的死亡率分别为每10万人口/年41.9、38.3和27.8例。在驾驶员死亡事故中,43%的拉丁裔、33%的非拉丁裔白人和27%的非拉丁裔黑人系了安全带。57%的拉丁裔驾驶员血液酒精含量≥0.01 g/dl(BAC+),非拉丁裔白人驾驶员的这一比例为47%,非拉丁裔黑人驾驶员为42%。在研究期间,拉丁裔和非拉丁裔白人驾驶员的BAC+变化不大,但非拉丁裔黑人驾驶员的BAC+有所下降。尽管安全带使用率上升且驾驶员BAC+趋于平稳,但年轻拉丁裔男性的机动车死亡率仍在上升。由于缺乏按种族/族裔划分的暴露数据,在辨别死亡率趋势差异的原因以及进一步了解特定种族/族裔群体的碰撞致死差异方面存在局限性。