Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut 06519, USA.
Inj Prev. 2011 Apr;17(2):102-7. doi: 10.1136/ip.2010.028886. Epub 2010 Dec 5.
The Latino Epidemiologic Paradox describes favourable health profiles for Latinos compared to non-Latino whites despite poverty, low education, and low access to healthcare. The objective of this study was to determine if the anomaly to the Latino Epidemiological Paradox and the Latino Adolescent Male Mortality Peak in California mortality data persists.
Cases were California residents (1999-2006) of any race and ethnicity that died (N = 1,866,743) in California from any cause of death. Mortality rates and rate ratios were calculated according to causes of death for 5 year age groups.
For males and females combined, age adjusted mortality rates were 509 for Latinos and 681 for non-Latino whites per 100,000/year. Latino male mortality rate ratios exceeded 1.0 compared to non-Latino white males only for age groups 15-19 years (1.41, 95% CI 1.35 to 1.49) and 20-24 years (1.24, 95% CI 1.19 to 1.29). Latinas had lower mortality rates than non-Latino white females for all ages over 15 years. Male homicide rates for Latinos increased over the study period, but did not reach the rates reported for the years 1989-1997. Both male homicide and motor vehicle crash mortality rates were higher for Latinos than non-Latino whites and peaked at 20-24 years. The Latino crash mortality rate exceeded the rate for non-Latino whites overall and for each year 2003-2006. Crash mortality for males aged 15-24 years increased from 2000 to 2006.
The anomaly and the mortality peak persist, with notable attribution to homicide and crashes. Without homicide, the mortality peak would not exist. Mortality disparities for Latino adolescent males from these two causes of death in California appear to be growing.
拉丁裔流行病学悖论描述了与非拉丁裔白人相比,拉丁裔在贫困、低教育水平和医疗保健机会有限的情况下具有更有利的健康状况。本研究的目的是确定加利福尼亚州死亡率数据中对拉丁裔流行病学悖论和拉丁裔青少年男性死亡率高峰的异常是否仍然存在。
本研究纳入了加利福尼亚州(1999-2006 年)任何种族和族裔的居民(N=1866743 人),他们死于任何原因的死亡。根据死亡原因计算了每 5 岁年龄组的死亡率和死亡率比。
对于男性和女性,调整年龄后的死亡率为每 10 万人/年 509 人,拉丁裔为 681 人,非拉丁裔白人为 681 人。与非拉丁裔白人男性相比,只有在 15-19 岁(1.41,95%CI 1.35-1.49)和 20-24 岁(1.24,95%CI 1.19-1.29)年龄组,拉丁裔男性的死亡率比超过 1.0。所有 15 岁以上的年龄段,拉丁裔女性的死亡率均低于非拉丁裔白人女性。在研究期间,拉丁裔男性的凶杀率有所增加,但仍未达到 1989-1997 年报告的水平。拉丁裔的凶杀和机动车事故死亡率均高于非拉丁裔白人,且在 20-24 岁时达到峰值。拉丁裔的碰撞死亡率总体上超过了非拉丁裔白人的死亡率,且在 2003-2006 年的每一年都超过了这一死亡率。15-24 岁男性的碰撞死亡率从 2000 年到 2006 年有所增加。
异常和死亡率高峰仍然存在,这主要归因于凶杀和车祸。如果没有凶杀,死亡率高峰将不会存在。加利福尼亚州,由于这两种原因导致的拉丁裔青少年男性的死亡率差距似乎在不断扩大。