心血管疾病和糖尿病正在推动美国超额死亡率的上升，而没有大学学历的成年人承担了大部分负担.
心血管疾病和糖尿病正在推动美国超额死亡率的上升，而没有大学学历的成年人承担了大部分负担
如果2010年之前的死亡率趋势继续下去，2023年美国成年人的死亡人数将比预期的多52.5万人。 更多的 than 90 percent of these 死亡s occurred among individuals without a bachelor’s degree and were largely caused by 心血管疾病s, underscoring how educational attainment can influence individuals’ health opportunities and outcomes.
Cardiometabolic diseases such as 心血管疾病 and type 2 糖尿病 have emerged as some of the key drivers of 日益恶化的 mortality rates in the United States over the last 15 years. 根据赫尔辛基大学公共卫生学院和明尼苏达大学的一项新澳门威尼斯人注册网站研究，受教育程度有限的人受到了这场危机的冲击。
对于没有学士学位的男性和女性来说，2011-2023年期间的死亡率明显高于2006-2010年期间死亡率的预期。 仅在2023年就有564,855例额外死亡，其中481,211例发生在没有ba的人群中，与2010年之前的趋势相比，这一人群的死亡率增加了26%。 相比之下，获得文学学士学位的人死亡率只增加了8%。 The study was 发表在 美国医学会健康论坛.
“While much attention has focused on how the COVID-19 pandemic led to life expectancy declines and 超额死亡率, our study shows that the United States was already experiencing an increasing number of excess 死亡s before the pandemic,” says study lead author Eugenio Paglino, postdoctoral researcher at the Helsinki Institute for Demography and Population Health at the University of Helsinki. “The pandemic further exacerbated these trends, with excess 死亡s peaking in 2021. However, even after COVID-19 mortality declined in 2023, excess 死亡s remained substantially higher than in the pre-pandemic period, highlighting the importance of looking at long-term mortality trends to uncover the mechanisms behind current developments.”
澳门威尼斯人注册网站研究结果强调了在全国范围内解决心脏代谢健康和慢性疾病的迫切需要，特别是可能解释为什么受教育程度较低的人不成比例地经历这些不良健康结果的社会和结构因素。
“The United States is facing a crisis of deteriorating mortality that is largely falling on the shoulders of those with less education,” says study senior and corresponding author 安德鲁·斯托克斯, associate professor of global health. “生活在农村地区，缺乏健康食品和良好营养，在不稳定的就业部门工作，这些都使他们难以吃得好、睡得好和锻炼。 教育从根本上构成了人们的工作机会，教育较少会给人们带来很多下游后果，使他们难以保持良好的健康。”
在这项澳门威尼斯人注册网站研究中，来自赫尔辛基大学和明尼苏达大学的斯托克斯及其同事利用全国死亡率和教育数据，澳门威尼斯人注册网站研究了2006年至2023年期间美国35岁及以上成年人的47,545,611例死亡，并将2011-2023年分为大流行前、大流行期和大流行后时期。
虽然不那么明显，但循环系统疾病也是文学学士或同等学位的成年人过量死亡的主要原因。
“Despite decades of progress in prevention and treatment, 心血管疾病s (including heart disease and stroke) remain the leading causes of 死亡 and major disability in the US and worldwide,” says 唐纳德-琼斯, director of 波士顿大学’s Framingham Center for Population and Prevention Science and primary investigator of the Framingham Heart Study, the longest-running heart disease study in the US. 劳埃德-琼斯同时也是波士顿大学乔巴尼亚和阿维迪医学院预防医学和流行病学科科长，他没有参与这项澳门威尼斯人注册网站研究。 “We know that the social drivers of health, including socioeconomic position, neighborhood environment, and, especially education, have a major impact on the predisposing risk factors for 心血管疾病 such as adverse diet, obesity, 糖尿病, blood pressure, and blood lipids. These findings reinforce and quantify the role that education can play in equipping people to manage their health and extend their longevity.”
在2023年，糖尿病也是导致没有文学学士学位的男性和女性超额死亡的主要原因，而在较小程度上，有文学学士学位的男性和女性也是如此。 澳门威尼斯人注册网站研究人员列举了一系列导致不健康食品消费增加的因素，从超加工食品的有效营销和广告到缺乏负担得起的营养丰富的食品。
“That over half of the excess 死亡s occurring in men and women without a BA were from circulatory diseases is a striking finding,” says 艾美莉亚便雅悯, professor of epidemiology and Robert Dawson Evans Distinguished Professor of Medicine at the Chobanian and Avedisian School of Medicine, who was not involved in the study. “In 2023, that represents over 260,000 excess 死亡s. 教育al attainment has profound health consequences.”
值得注意的是，调查结果还表明，药物过量是造成受教育程度较低的男性过度死亡的一个重要因素，但在受教育程度较高的男性中，这一因素的影响要小得多。
斯托克斯说：“这一观察结果反映了处方药使用的下游后果，在21世纪初导致广泛的药物依赖和过量使用，然后转化为使用海洛因、芬太尼和其他在那个时期更容易获得的产品。” “2023年，药物中毒仍然是没有学士学位的男性超额死亡的主要原因，这一事实表明，绝望死亡在美国的死亡率中一直扮演着重要角色。”
“This work is a clarion call for us to understand the health threats facing Americans with less education,” says 玛丽亚针对, chair and professor of epidemiology, who was not involved in the study but has studied how education is a predictor of health. “The mortality differences reported here suggest that we need to consider the ’causes of the causes’ of social inequalities. History demonstrates it is possible to either shrink or magnify these disparities via public health and policy actions.”
澳门威尼斯人注册网站研究人员确实观察到一些有希望的死亡率趋势。 在拥有文学学士学位的妇女中，与2006-2010年的总数相比，2023年因癌症和其他外部原因（如事故和暴力）造成的死亡人数有所减少。
“If we had simply maintained the progress we were making for each of these education groups 20 years ago, there are half a million Americans who died in 2023 who wouldn’t have died,” says study coauthor 伊丽莎白wrigley棒球场, associate professor of sociology at the University of Minnesota, Twin Cities. “Almost 92 percent of them didn’t have a college degree. 导致这些死亡的原因如此之多，包括心血管疾病、药物过量和糖尿病，这一事实告诉我们，在谁能从健康进步中受益方面，存在着巨大的鸿沟。”
她补充说，教育发挥作用的最重要方式之一是它为人们提供的工作机会。 “We hope these results will contribute to a conversation about the ways that American workplaces aren’t always conducive to good health, and what would allow American workers to live longer lives.”