■近年来,过早的“绝望的死亡”(即,由于酒精,吸毒,和自杀)在美国中年白人中受到了大众媒体的越来越多的关注,然而,关于如何解释非洲裔美国年轻人过早死亡的讨论较少。在这项研究中,我们研究了与绝望死亡相关的因素(饮酒,吸毒,吸烟)和环境因素(感知的歧视,社会经济地位,邻里条件)作为非洲裔美国人在65岁之前过早死亡的预测因素。
■杰克逊心脏研究(JHS)是一项针对杰克逊非裔美国人的纵向队列研究,密西西比州,大都市统计区。我们纳入基线年龄小于65岁的参与者(n=4000)。参与者的注册始于2000年,这些分析的数据收集到2019年。为了检查死亡率的预测因素,我们计算了多变量调整后的危险比(HR;95%CI),使用根据年龄调整的Cox比例风险模型,性别,理想的心血管健康指标,吸毒,酒精摄入量,功能状态,癌症,慢性肾病,哮喘,腰围,抑郁症,收入,教育,健康保险状况,感知到的邻里安全,和终身歧视。
■我们的队列中有230人死亡,从2001年到2019年。在调整所有协变量后,男性(HR,1.50;95%CI,1.11-2.03),使用药物的参与者(HR,1.53;95%CI,1.13-2.08),有大量饮酒事件(HR,1.71;95%CI,1.22-2.41),报告的0-1个理想心血管健康指标(HR,1.78;95%CI,1.06-3.02),患有癌症(HR,2.38;95%CI,1.41-4.01),具有较差的功能状态(HR,1.68;95%CI,1.19-2.37),或家庭年收入低于25,000美元(人力资源,1.63;95%CI,1.02-2.62)更有可能在65岁之前死亡。
■在我们庞大的非裔美国男性和女性群体中,过早死亡的临床预测因素包括不良的心血管健康和癌症,社会预测因素包括低收入,吸毒,大量饮酒,现在是一个吸烟者。临床和社会干预是必要的,以防止非洲裔美国人过早死亡。
UNASSIGNED: In recent years, premature \"deaths of despair\" (ie, due to alcohol, drug use, and suicide) among middle-aged White Americans have received increased attention in the popular press, yet there has been less discussion on what explains premature deaths among young African Americans. In this study, we examined factors related to deaths of despair (alcohol use, drug use, smoking) and contextual factors (perceived discrimination, socioeconomic status, neighborhood conditions) as predictors of premature deaths before the age of 65 years among African Americans.
UNASSIGNED: The Jackson Heart Study (JHS) is a longitudinal cohort study of African Americans in the Jackson,
Mississippi, metropolitan statistical area. We included participants younger than 65 years at baseline (n=4000). Participant enrollment began in 2000 and data for these analyses were collected through 2019. To examine predictors of mortality, we calculated multivariable adjusted hazard ratios (HRs; 95% CI), using Cox proportional hazard models adjusted for age, sex, ideal cardiovascular health metrics, drug use, alcohol intake, functional status, cancer, chronic kidney disease, asthma, waist circumference, depression, income, education, health insurance status, perceived neighborhood safety, and exposure to lifetime discrimination.
UNASSIGNED: There were 230 deaths in our cohort, which spanned from 2001-2019. After adjusting for all covariates, males (HR, 1.50; 95% CI, 1.11-2.03), participants who used drugs (HR, 1.53; 95% CI, 1.13-2.08), had a heavy alcohol drinking episode (HR, 1.71; 95% CI, 1.22-2.41), reported 0-1 ideal cardiovascular health metrics (HR, 1.78; 95% CI, 1.06-3.02), had cancer (HR, 2.38; 95% CI, 1.41-4.01), had poor functional status (HR, 1.68; 95% CI, 1.19-2.37), or with annual family income less than $25,000 (HR, 1.63; 95% CI, 1.02-2.62) were more likely to die before 65 years of age.
UNASSIGNED: In our large cohort of African American men and women, clinical predictors of premature death included poor cardiovascular health and cancer, and social predictors included low income, drug use, heavy alcohol use, and being a current smoker. Clinical and social interventions are warranted to prevent premature mortality in African Americans.