エスニシティ、平均寿命のデータは、ヘルスエクイティーの取り組みに役立ちます。(Ethnicity, life expectancy data can aid in health equity efforts)

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2023-03-10 ジョージア工科大学

世界中で多くの人々が健康で長寿命になっているものの、健康格差が依然として大きな問題であることが、ジョージア工科大学の研究によって明らかになった。
研究者たちは、英国の民族的な健康格差と死亡リスク要因について分析し、個別に修正可能な死亡リスク要因を特定した。異なる民族グループの死亡率と死亡リスク要因が非常に異なることから、対象を特定した介入がより健康的な社会を実現するために重要であることを強調している。
研究チームは、UK Biobankのデータを分析し、アジア人、黒人、白人の参加者の死因を比較した。これにより、異なる民族グループの死因が明らかになった。
今後の研究では、アメリカにおける人種的・民族的な健康格差について調査する予定である。

<関連情報>

UK Biobankにおける死亡率と集団特異的危険因子の民族間格差 Ethnic disparities in mortality and group-specific risk factors in the UK Biobank

Kara Keun Lee,Emily T. Norris,Lavanya Rishishwar,Andrew B. Conley,Leonardo Mariño-Ramírez,John F. McDonald,I. King Jordan
PLOS Global Health  Published: February 23, 2023
DOI:https://doi.org/10.1371/journal.pgph.0001560

Abstract

Despite a substantial overall decrease in mortality, disparities among ethnic minorities in developed countries persist. This study investigated mortality disparities and their associated risk factors for the three largest ethnic groups in the United Kingdom: Asian, Black, and White. Study participants were sampled from the UK Biobank (UKB), a prospective cohort enrolled between 2006 and 2010. Genetics, biological samples, and health information and outcomes data of UKB participants were downloaded and data-fields were prioritized based on participants with death registry records. Kaplan-Meier method was used to evaluate survival differences among ethnic groups; survival random forest feature selection followed by Cox proportional-hazard modeling was used to identify and estimate the effects of shared and ethnic group-specific mortality risk factors. The White ethnic group showed significantly worse survival probability than the Asian and Black groups. In all three ethnic groups, endoscopy and colonoscopy procedures showed significant protective effects on overall mortality. Asian and Black women show lower relative risk of mortality than men, whereas no significant effect of sex was seen for the White group. The strongest ethnic group-specific mortality associations were ischemic heart disease for Asians, COVID-19 for Blacks, and cancers of respiratory/intrathoracic organs for Whites. Mental health-related diagnoses, including substance abuse, anxiety, and depression, were a major risk factor for overall mortality in the Asian group. The effect of mental health on Asian mortality, particularly for digestive cancers, was exacerbated by an observed hesitance to answer mental health questions, possibly related to cultural stigma. C-reactive protein (CRP) serum levels were associated with both overall and cause-specific mortality due to COVID-19 and digestive cancers in the Black group, where elevated CRP has previously been linked to psychosocial stress due to discrimination. Our results point to mortality risk factors that are group-specific and modifiable, supporting targeted interventions towards greater health equity.

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