@article {de Havenon10.1212 / WNL。0000000000207446,作者= {de Havenon亚当和莉莉周W和卡伦C约翰斯顿和Neha Dangayach和约翰·内伊和Shadi Yaghi理查德·夏尔马和Mehdi Abbasi阿伦Delic和珍妮弗•朱尔Majersik Mohammad Anadani和David l . Tirschwell凯文Navin Sheth}, title ={20年差距趋势在美国中风死亡率年龄、种族、地理、和社会经济地位},elocation-id = {10.1212 / WNL。={2023}0000000000207446},年,doi = {10.1212 / WNL。出版商0000000000207446}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘= {BackgroundIn 2017年CDC发布了海啸预警,经过几十年的持续下首页降,2013年中风死亡率平稳,尤其是在年轻人和没有明确的来源。这个分析的目的是了解健康问题社会决定因素是否影响中风死亡率的趋势。MethodsWe进行了纵向分析县级缺血性中风和出血性中风的死亡率每100000成年人,从1999年到2018年使用贝叶斯时空平滑疾控中心的数据集按年龄分层(35 - 64(年轻),> = 65(旧)],然后由县级健康问题社会决定因素。我们报告中风死亡率由县和比例变化相比,中风死亡率在2014 - 18 2009 - 13。ResultsWe包括的数据来自3082个县为老年人年轻的个人和3019个县。中风的死亡率在2013年开始为年轻人增加(p \ < 0.001)和中风死亡率下降的斜率锥形的老年人(p < 0.001)。我们研究的20年期间,县和高社会剥夺指数> = 10 \ %黑人居民一直都中风的死亡率最高的年龄群体。比较2014 - 18 - 2009 - 13日大增加年轻人{\ textquoteright}中风死亡率被认为在县> = 90 \ %(和\ < 90 \ %)非西班牙裔白人个体(3.2 \ %平均死亡率变化和1.7 \ % \ p < 0.001),农村人口(与城市)(2.6 \ %和2.0 \ %,p = 0.019),低(与高)的医疗保险比例(2.9 \ %和1.9 \ %,p = 0.002),和高(或低)药物滥用和自杀死亡率(2.8 vs 1.9 \ %, p = 0.008;3.3 \ \ % % vs 1.5, p < 0.001)。 In contrast to the younger individuals, in older individuals the associations with increased death rates were with more traditional social determinants of health such as the Social Deprivation Index, urban location, unemployment rate, and proportion of Black race and Hispanic ethnicity residents.DiscussionImprovements in the United States{\textquoteright} stroke death rate are slowing and even reversing in younger individuals and many US counties. County-level increases in stroke death rate were associated with distinct social determinants of health for younger versus older individuals. These findings may inform targeted public health strategies.}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/early/2023/05/31/WNL.0000000000207446}, eprint = {//www.ez-admanager.com/content/early/2023/05/31/WNL.0000000000207446.full.pdf}, journal = {Neurology} }