挪威 2005-2015 年家庭收入与预期寿命和特定原因死亡率的关系。
Association of Household Income With Life Expectancy and Cause-Specific Mortality in Norway, 2005-2015.
机构信息
Norwegian Institute of Public Health, Oslo, Norway.
University of Oslo, Oslo, Norway.
出版信息
JAMA. 2019 May 21;321(19):1916-1925. doi: 10.1001/jama.2019.4329.
IMPORTANCE
Examining causes of death and making comparisons across countries may increase understanding of the income-related differences in life expectancy.
OBJECTIVES
To describe income-related differences in life expectancy and causes of death in Norway and to compare those differences with US estimates.
DESIGN AND SETTING
A registry-based study including all Norwegian residents aged at least 40 years from 2005 to 2015.
EXPOSURES
Household income adjusted for household size.
MAIN OUTCOMES AND MEASURES
Life expectancy at 40 years of age and cause-specific mortality.
RESULTS
In total, 3 041 828 persons contributed 25 805 277 person-years and 441 768 deaths during the study period (mean [SD] age, 59.3 years [13.6]; mean [SD] number of household members per person, 2.5 [1.3]). Life expectancy was highest for women with income in the top 1% (86.4 years [95% CI, 85.7-87.1]) which was 8.4 years (95% CI, 7.2-9.6) longer than women with income in the lowest 1%. Men with the lowest 1% income had the lowest life expectancy (70.6 years [95% CI, 69.6-71.6]), which was 13.8 years (95% CI, 12.3-15.2) less than men with the top 1% income. From 2005 to 2015, the differences in life expectancy by income increased, largely attributable to deaths from cardiovascular disease, cancers, chronic obstructive pulmonary disease, and dementia in older age groups and substance use deaths and suicides in younger age groups. Over the same period, life expectancy for women in the highest income quartile increased 3.2 years (95% CI, 2.7-3.7), while life expectancy for women in the lowest income quartile decreased 0.4 years (95% CI, -1.0 to 0.2). For men, life expectancy increased 3.1 years (95% CI, 2.5-3.7) in the highest income quartile and 0.9 years (95% CI, 0.2-1.6) in the lowest income quartile. Differences in life expectancy by income levels in Norway were similar to differences observed in the United States, except that life expectancy was higher in Norway in the lower to middle part of the income distribution in both men and women.
CONCLUSIONS AND RELEVANCE
In Norway, there were substantial and increasing gaps in life expectancy by income level from 2005 to 2015. The largest differences in life expectancy between Norway and United States were for individuals in the lower to middle part of the income distribution.
重要性
研究死亡原因并比较各国之间的情况可能有助于更好地理解收入与预期寿命之间的差异。
目的
描述挪威收入与预期寿命之间的差异以及死亡原因，并与美国的估计值进行比较。
设计和设置
这是一项基于登记的研究，包括 2005 年至 2015 年期间所有至少 40 岁的挪威居民。
暴露因素
家庭规模调整后的家庭收入。
主要结果和测量指标
40 岁时的预期寿命和特定原因的死亡率。
结果
在整个研究期间，共有 3041828 人贡献了 25805277 人年和 441768 人死亡（平均[标准差]年龄为 59.3 岁[13.6]；平均[标准差]每人家庭人数为 2.5[1.3]）。收入最高的 1%的女性预期寿命最高（86.4 岁[95%置信区间，85.7-87.1]），比收入最低的 1%的女性长 8.4 岁（95%置信区间，7.2-9.6）。收入最低的 1%的男性预期寿命最短（70.6 岁[95%置信区间，69.6-71.6]），比收入最高的 1%的男性短 13.8 岁（95%置信区间，12.3-15.2）。从 2005 年到 2015 年，收入对预期寿命的影响差异有所增加，这主要归因于心血管疾病、癌症、慢性阻塞性肺疾病和痴呆在老年人群中的死亡以及年轻人群中药物使用和自杀导致的死亡。在此期间，最高收入四分位组女性的预期寿命增加了 3.2 岁（95%置信区间，2.7-3.7），而最低收入四分位组女性的预期寿命减少了 0.4 岁（95%置信区间，-1.0 至 0.2）。对于男性，最高收入四分位组的预期寿命增加了 3.1 岁（95%置信区间，2.5-3.7），最低收入四分位组的预期寿命增加了 0.9 岁（95%置信区间，0.2-1.6）。挪威的预期寿命与收入水平之间存在实质性和不断扩大的差距，这一差距从 2005 年到 2015 年持续存在。挪威和美国之间预期寿命的最大差异存在于收入分布的中下部分。
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