英国研究人员发现从1970-2008年,英国在控制儿童、青少年、年轻人的死亡数上取得的成果与其他同等国家相比是不匹配的,尤其是在婴儿死亡和非传染性疾病的死亡。Lancet为此专门刊登一篇文章

—2014年9月6日《柳叶刀》


中文翻译


 

【题目】1970-2008年,英国0-24岁年轻人死亡数与EU15欧盟15+国家的比较:WHO死亡数数据库的分析。

【译文】

背景:英国对儿童和年轻人的死亡数率的关注增加程度已经落后于其他相似的国家。

方法:根据WHO世界死亡数数据库1970-2008年的数据,我们分析死亡登记的数据,比较英国与其他欧盟成员国(20045月之前排除英国,加入澳大利亚、加拿大和挪威[the EU15+ 国家]024岁儿童和年轻人的死亡数。根据全球疾病负担的分类,我们将不同的死因进行分组:传染性、营养的、或母亲体的原因 ;非传染性疾病和损伤。英国的死亡数趋势与EU15+国家死亡数四分位数进行比较。我们用拟似然泊松模型来探讨截距和斜率在英国和EU15+国家间的差异。

发现:在1970年,英国1-24岁儿童和年轻人的总死亡数处于最佳的EU15+四分位数(<25th百分位数),而英国的婴儿死亡数与EU15+的中位数相似。与EU15+国家相比,之后英国在各个年龄组的死亡数的降幅均较EU15+国家小。到2008年,英国新生儿、婴儿、1-4岁的儿童的总死亡数处于EU15+四分位数(>75th 百分位数)中最差的水平。在2008年,与EU15+中位数相比,英国婴儿年度超出额死亡人数是1035人,1-9岁儿童是134人。英国非传染性疾病的死亡的人数有所的下降,从1970年与EU15+的中位数相当,到2008年全年龄组的四分位数中最差水平,2008年英国年均因非传染性疾病超额死亡数是446人(208人是10-24岁的年轻人)。在研究的时间段内,英国全年龄组因意外伤害的所致死亡数仍然处于EU15+四分位数中最好水平。

说明:自从1970年至今40年以来,英国在控制儿童、青少年、年轻人的死亡数上取得的成果与其落后于其他同等国家,尤其是在婴儿死亡和非传染性疾病(包括神经精神疾病)的死亡方面。英国需要明确并解决可以处理的导致婴儿、儿童、年轻人慢性疾患不良健康结局的社会决定因素和健康体系因素。

 

英文原稿


 

[Title] Deaths in young people aged 0-24 years in the UK compared with the EU15+ countries,
1970-2008: analysis of the WHO Mortality Database
[Authors] Russell M Viner, Dougal S Hargreaves, Carolyn Coffey, George C Patton, Ingrid Wolfe
[Abstract]
Background:Concern is growing that mortality and health in children and young people in the UK lags
behind that of similar countries.
Methods: We analysed death registry data provided to the WHO Mortality Database to compare UK
mortality for children and young people aged 0-24 years with that of European Union member states
(before May, 2004, excluding the UK, plus Australia, Canada, and Norway [the EU15+ countries])
from 1970 to 2008 using the WHO World Mortality Database. We grouped causes of death by Global
Burden of Disease classification: communicable, nutritional, or maternal causes; non-communicable
disorders; and injury. UK mortality trends were compared with quartiles of mortality in EU15+ countries.
We used quasi-likelihood Poisson models to explore differences between intercepts and slopes between
the UK and the EU15+ countries.
Findings: In 1970, UK total mortality was in the best EU15+ quartile (<25th centile) for children and
young people aged 1-24 years, with UK infant mortality similar to the EU15+ median. Subsequent
mortality reductions in the UK were smaller than were those in the EU15+ countries in all age groups.
By 2008, total mortality for neonates, infants, and children aged 1-4 years in the UK was in the worst
EU15+ quartile (>75th centile). In 2008, UK annual excess mortality compared with the EU15+ median
was 1035 deaths for infants and 134 for children aged 1-9 years. Mortality from non-communicable
diseases in the UK fell from being roughly equivalent to the EU15+ median in 1970 to the worst quartile
in all age groups by 2008, with 446 annual excess deaths from non-communicable diseases in the UK
(280 for young people aged 10-24 years) in 2008. UK mortality from injury remained in the best
EU15+ quartile for the study period in all age groups.
Interpretation: The UK has not matched the gains made in child, adolescent, and young adult mortality
by other comparable countries in the 40 years since 1970, particularly for infant deaths and mortality
from non-communicable diseases, including neuropsychiatric disorders. The UK needs to identify and
address amenable social determinants and health system factors that lead to poor health outcomes for
infants and for children and young people with chronic disorders.

原文地址

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60485-2/abstract

 

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