本文由小咖机器人翻译整理

期刊来源：JAMA

原文链接：https://doi.org/10.1001/jama.2024.3908

摘要内容如下：

重要性

近年来，美国年轻人的死亡率有所上升。缺乏对种族和民族差异在这些增长中的作用的理解。

目的

比较西班牙裔和非西班牙裔美国印第安人或阿拉斯加土著人、亚洲或太平洋岛民、黑人和白人青年的全因和特定原因死亡率趋势和比率。

设计、设置和参与者

这项横断面研究利用美国疾病控制和预防中心流行病学研究数据库的广泛在线数据，对1至19岁青少年的总死亡率进行了时间分析（1999-2020年）和比较（2016-2020年）。数据分析时间为2023年6月30日至2024年1月17日。

主要成果和措施

比较了主要潜在死亡原因的合并死亡率、全因死亡率和每10万名青年（以下简称“每10万人”）的病因特异性死亡率。伤害按机制和意图分类。

结果

1999年至2020年，美国青年死亡人数为491680人，其中8894人（1.8%）为美洲印第安人或阿拉斯加土著人，14507人（3.0%）为亚裔或太平洋岛民，110154人（22.4%）为黑人，89251人（18.2%）为西班牙裔，267452人（54.4%）为白人青年。2016年至2020年，美国印第安人或阿拉斯加土著青年的全因死亡率为48.79/10万（95%CI，46.58-51.00），亚裔或太平洋岛民青年的全因死亡率为15.25/10万（95%CI，14.75-15.76），黑人青年的全因死亡率为42.33/10万（95%CI，41.81-42.86），西班牙裔青年的全因死亡率为21.48/10万（95%CI，21.19-21.77），23.86-24.28）在白人青年中。与白人青年相比，美国印第安人或阿拉斯加土著青年的全因死亡率为2.03（95%CI，1.93-2.12），亚裔或太平洋岛民青年为0.63（95%CI，0.61-0.66），黑人青年为1.76（95%CI，1.73-1.79），西班牙裔青年为0.89（95%CI，0.88-0.91）。2016年至2020年，黑人青年的凶杀率为每10万人12.81（95%CI，12.52-13.10），是白人青年的10.20（95%CI，9.75-10.66）倍。美国印第安人或阿拉斯加土著青年的自杀率为11.37（95%CI，10.30-12.43）/10万，是白人青年的2.60（95%CI，2.35-2.86）倍。黑人青年的火器死亡率为12.88（95%CI，12.59-13.17）/10万，是白人青年的4.14（95%CI，4.00-4.28）倍。美国印第安人或阿拉斯加土著青年的火器死亡率为6.67（95%CI，5.85-7.49）/10万，是白人青年的2.14（95%CI，1.88-2.43）倍。黑人青年的哮喘死亡率为1.10（95%CI，1.01-1.18）/10万，是白人青年的7.80（95%CI，6.78-8.99）倍。

结论和相关性

在这项研究中，几乎所有与近期青年死亡率上升有关的伤害和疾病的主要原因都存在种族和民族差异。要解决影响美国印第安人或阿拉斯加土著人和黑人青年的日益扩大的差异，就需要努力防止杀人和自杀，特别是涉及枪支的事件。

英文原文如下：

Abstracts

Importance  Mortality rates in US youth have increased in recent years. An understanding of the role of racial and ethnic disparities in these increases is lacking.

Objective  To compare all-cause and cause-specific mortality trends and rates among youth with Hispanic ethnicity and non-Hispanic American Indian or Alaska Native, Asian or Pacific Islander, Black, and White race.

Design, Setting, and Participants  This cross-sectional study conducted temporal analysis (1999-2020) and comparison of aggregate mortality rates (2016-2020) for youth aged 1 to 19 years using US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Data were analyzed from June 30, 2023, to January 17, 2024.

Main Outcomes and Measures  Pooled, all-cause, and cause-specific mortality rates per 100 000 youth (hereinafter, per 100 000) for leading underlying causes of death were compared. Injuries were classified by mechanism and intent.

Results  Between 1999 and 2020, there were 491 680 deaths among US youth, including 8894 (1.8%) American Indian or Alaska Native, 14 507 (3.0%) Asian or Pacific Islander, 110 154 (22.4%) Black, 89 251 (18.2%) Hispanic, and 267 452 (54.4%) White youth. Between 2016 and 2020, pooled all-cause mortality rates were 48.79 per 100 000 (95% CI, 46.58-51.00) in American Indian or Alaska Native youth, 15.25 per 100 000 (95% CI, 14.75-15.76) in Asian or Pacific Islander youth, 42.33 per 100 000 (95% CI, 41.81-42.86) in Black youth, 21.48 per 100 000 (95% CI, 21.19-21.77) in Hispanic youth, and 24.07 per 100 000 (95% CI, 23.86-24.28) in White youth. All-cause mortality ratios compared with White youth were 2.03 (95% CI, 1.93-2.12) among American Indian or Alaska Native youth, 0.63 (95% CI, 0.61-0.66) among Asian or Pacific Islander youth, 1.76 (95% CI, 1.73-1.79) among Black youth, and 0.89 (95% CI, 0.88-0.91) among Hispanic youth. From 2016 to 2020, the homicide rate in Black youth was 12.81 (95% CI, 12.52-13.10) per 100 000, which was 10.20 (95% CI, 9.75-10.66) times that of White youth. The suicide rate for American Indian or Alaska Native youth was 11.37 (95% CI, 10.30-12.43) per 100 000, which was 2.60 (95% CI, 2.35-2.86) times that of White youth. The firearm mortality rate for Black youth was 12.88 (95% CI, 12.59-13.17) per 100 000, which was 4.14 (95% CI, 4.00-4.28) times that of White youth. American Indian or Alaska Native youth had a firearm mortality rate of 6.67 (95% CI, 5.85-7.49) per 100 000, which was 2.14 (95% CI, 1.88- 2.43) times that of White youth. Black youth had an asthma mortality rate of 1.10 (95% CI, 1.01-1.18) per 100 000, which was 7.80 (95% CI, 6.78-8.99) times that of White youth.

Conclusions and Relevance  In this study, racial and ethnic disparities were observed for almost all leading causes of injury and disease that were associated with recent increases in youth mortality rates. Addressing the increasing disparities affecting American Indian or Alaska Native and Black youth will require efforts to prevent homicide and suicide, especially those events involving firearms.

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