Trends in health equity in mortality in the United States, 1969–2019

Abstract:: Rationale: Health equity is a significant concern of public health, yet a comprehensive assessment of health equity in the United States over time is lacking. While one might presume that overall health will improve with rising living standards, no such presumption is warranted for healt...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Nathaniel W. Anderson, Frederick J. Zimmerman
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Public aspects of medicine RA1-1270 Social sciences (General) H1-99
Acceso en línea:	https://doaj.org/article/989d779106fa43ed85deec144c04abd8
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:989d779106fa43ed85deec144c04abd8
record_format	dspace
spelling	oai:doaj.org-article:989d779106fa43ed85deec144c04abd82021-11-26T04:34:56ZTrends in health equity in mortality in the United States, 1969–20192352-827310.1016/j.ssmph.2021.100966https://doaj.org/article/989d779106fa43ed85deec144c04abd82021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S235282732100241Xhttps://doaj.org/toc/2352-8273Abstract:: Rationale: Health equity is a significant concern of public health, yet a comprehensive assessment of health equity in the United States over time is lacking. While one might presume that overall health will improve with rising living standards, no such presumption is warranted for health equity, which may decline even as average health improves. Objectives: To assess trends in national and state-level health equity in mortality for people up to age 25, ages 25–64 and aged 65 and older. Methods: A health equity metric was calculated as the weighted mean life expectancy relative to a benchmark level, defined as the life expectancy of the most socially-privileged subpopulation (white, non-Latinx males with a college education or higher).We analyzed 114,558,346 death records from the National Center for Health Statistics, from January 1, 1969 to December 31, 2019 to estimate health equity annually at the national and state-level. Using ICD-9/ICD-10 classification codes, inequities in health were decomposed by major causes of death. Results: From 1969 to 2019, health equity in the United States improved (+0.36 points annually [95% CI 0.31–0.41]), albeit at a slower rate over the last two decades (+0.08 points annually [95% CI 0.03–0.14] from 2000 to 2019, compared to +0.57 points annually from 1969 to 2000 [95% CI 0.50–0.65]). Health equity among those under 25 improved substantially (+0.82 points annually [95% CI 0.75–0.89]) but remained flat for adults 25–64 (−0.01 points annually [95% CI -0.03-0.003]) For those over 65, health equity displayed a downward trend (−0.08 points annually [95% CI -0.09 to −0.07]). Gains in equity from reduced unintentional injuries and homicides have been largely offset by rising mortality attributable to drug overdoses. Conclusions: The US is failing to advance health equity, especially for adults. Keeping policy-makers accountable to a summary measure of health equity may help coordinate efforts at improving population health.Nathaniel W. AndersonFrederick J. ZimmermanElsevierarticlePublic aspects of medicineRA1-1270Social sciences (General)H1-99ENSSM: Population Health, Vol 16, Iss , Pp 100966- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Public aspects of medicine RA1-1270 Social sciences (General) H1-99
spellingShingle	Public aspects of medicine RA1-1270 Social sciences (General) H1-99 Nathaniel W. Anderson Frederick J. Zimmerman Trends in health equity in mortality in the United States, 1969–2019
description	Abstract:: Rationale: Health equity is a significant concern of public health, yet a comprehensive assessment of health equity in the United States over time is lacking. While one might presume that overall health will improve with rising living standards, no such presumption is warranted for health equity, which may decline even as average health improves. Objectives: To assess trends in national and state-level health equity in mortality for people up to age 25, ages 25–64 and aged 65 and older. Methods: A health equity metric was calculated as the weighted mean life expectancy relative to a benchmark level, defined as the life expectancy of the most socially-privileged subpopulation (white, non-Latinx males with a college education or higher).We analyzed 114,558,346 death records from the National Center for Health Statistics, from January 1, 1969 to December 31, 2019 to estimate health equity annually at the national and state-level. Using ICD-9/ICD-10 classification codes, inequities in health were decomposed by major causes of death. Results: From 1969 to 2019, health equity in the United States improved (+0.36 points annually [95% CI 0.31–0.41]), albeit at a slower rate over the last two decades (+0.08 points annually [95% CI 0.03–0.14] from 2000 to 2019, compared to +0.57 points annually from 1969 to 2000 [95% CI 0.50–0.65]). Health equity among those under 25 improved substantially (+0.82 points annually [95% CI 0.75–0.89]) but remained flat for adults 25–64 (−0.01 points annually [95% CI -0.03-0.003]) For those over 65, health equity displayed a downward trend (−0.08 points annually [95% CI -0.09 to −0.07]). Gains in equity from reduced unintentional injuries and homicides have been largely offset by rising mortality attributable to drug overdoses. Conclusions: The US is failing to advance health equity, especially for adults. Keeping policy-makers accountable to a summary measure of health equity may help coordinate efforts at improving population health.
format	article
author	Nathaniel W. Anderson Frederick J. Zimmerman
author_facet	Nathaniel W. Anderson Frederick J. Zimmerman
author_sort	Nathaniel W. Anderson
title	Trends in health equity in mortality in the United States, 1969–2019
title_short	Trends in health equity in mortality in the United States, 1969–2019
title_full	Trends in health equity in mortality in the United States, 1969–2019
title_fullStr	Trends in health equity in mortality in the United States, 1969–2019
title_full_unstemmed	Trends in health equity in mortality in the United States, 1969–2019
title_sort	trends in health equity in mortality in the united states, 1969–2019
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/989d779106fa43ed85deec144c04abd8
work_keys_str_mv	AT nathanielwanderson trendsinhealthequityinmortalityintheunitedstates19692019 AT frederickjzimmerman trendsinhealthequityinmortalityintheunitedstates19692019
_version_	1718409856149356544

Trends in health equity in mortality in the United States, 1969–2019

Ejemplares similares