Variation in life expectancy and mortality by cause among neighbourhoods in King County, WA, USA, 1990–2014: a census tract-level analysis for the Global Burden of Disease Study 2015
| Autor: | Eli Kern, Shreya Shirude, Ali H. Mokdad, Samuel Finegold, Christopher J L Murray, Abraham D. Flaxman, Jeffrey S. Duchin, Rebecca W. Stubbs, Charlton S K H Callender, Amelia Bertozzi-Villa, David Fleming, Amy Laurent, Chloe Morozoff, Laura Dwyer-Lindgren |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Washington Gerontology Inequality media_common.quotation_subject Population health 030204 cardiovascular system & hematology Global Burden of Disease 03 medical and health sciences Life Expectancy 0302 clinical medicine Residence Characteristics Cause of Death Humans 030212 general & internal medicine Mortality Aged media_common Cause of death Aged 80 and over lcsh:Public aspects of medicine Mortality rate Public Health Environmental and Occupational Health lcsh:RA1-1270 Censuses Health Status Disparities Redistribution (cultural anthropology) Census Geography Years of potential life lost Life expectancy Female Demography |
| Zdroj: | The Lancet Public Health, Vol 2, Iss 9, Pp e400-e410 (2017) |
| ISSN: | 2468-2667 |
| Popis: | Summary Background Health outcomes are known to vary at both the country and local levels, but trends in mortality across a detailed and comprehensive set of causes have not been previously described at a very local level. Life expectancy in King County, WA, USA, is in the 95th percentile among all counties in the USA. However, little is known about how life expectancy and mortality from different causes of death vary at a local, neighbourhood level within this county. In this analysis, we estimated life expectancy and cause-specific mortality within King County to describe spatial trends, quantify disparities in mortality, and assess the contribution of each cause of death to overall disparities in all-cause mortality. Methods We applied established so-called garbage code redistribution algorithms and small area estimation methods to death registration data for King County to estimate life expectancy, cause-specific mortality rates, and years of life lost (YLL) rates from 152 causes of death for 397 census tracts from Jan 1, 1990, to Dec 31, 2014. We used the cause list developed for the Global Burden of Disease 2015 study for this analysis. Deaths were tabulated by age group, sex, census tract, and cause of death. We used Bayesian mixed-effects regression models to estimate mortality overall and from each cause. Findings Between 1990 and 2014, life expectancy in King County increased by 5·4 years (95% uncertainty interval [UI] 5·0–5·7) among men (from 74·0 years [73·7–74·3] to 79·3 years [79·1–79·6]) and by 3·4 years (3·0–3·7) among women (from 80·0 years [79·7–80·2] to 83·3 years [83·1–83·5]). In 2014, life expectancy ranged from 68·4 years (95% UI 66·9–70·1) to 86·7 years (85·0–88·2) for men and from 73·6 years (71·6–75·5) to 88·4 years (86·9–89·9) for women among census tracts within King County. Rates of YLL by cause also varied substantially among census tracts for each cause of death. Geographical areas with relatively high and relatively low YLL rates differed by cause. In general, causes of death responsible for more YLLs overall also contributed more significantly to geographical inequality within King County. However, certain causes contributed more to inequality than to overall YLLs. Interpretation This census tract-level analysis of life expectancy and cause-specific YLL rates highlights important differences in health among neighbourhoods in King County that are masked by county-level estimates. Efforts to improve population health in King County should focus on reducing geographical inequality, by targeting those health conditions that contribute the most to overall YLLs and to inequality. This analysis should be replicated in other locations to more fully describe fine-grained local-level variation in population health and contribute to efforts to improve health while reducing inequalities. Funding John W Stanton and Theresa E Gillespie. |
| Databáze: | OpenAIRE |
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