论文
论文标题：Understanding longevity in Hong Kong: a comparative study with long-living, high-income countries
作者：Michael Y Ni, Vladimir Canudas-Romo, Jian Shi, Francis P Flores, Mathew S C Chow, Xiaoxin I Yao, Sai Yin Ho, Tai Hing Lam, C Mary Schooling, Alan D Lopez, Majid Ezzati, Gabriel M Leung
期刊：The Lancet Public Health
发表时间：2021/11/10
数字识别码：10.1016/S2468-2667(21)00208-5
摘要：BackgroundSince 2013, Hong Kong has sustained the world's highest life expectancy at birth—a key indicator of population health. The reasons behind this achievement remain poorly understood but are of great relevance to both rapidly developing and high-income regions. Here, we aim to compare factors behind Hong Kong's survival advantage over long-living, high-income countries.MethodsLife expectancy data from 1960–2020 were obtained for 18 high-income countries in the Organisation for Economic Co-operation and Development from the Human Mortality Database and for Hong Kong from Hong Kong's Census and Statistics Department. Causes of death data from 1950–2016 were obtained from WHO's Mortality Database. We used truncated cross-sectional average length of life (TCAL) to identify the contributions to survival differences based on 263 million deaths overall. As smoking is the leading cause of premature death, we also compared smoking-attributable mortality between Hong Kong and the high-income countries.FindingsFrom 1979–2016, Hong Kong accumulated a substantial survival advantage over high-income countries, with a difference of 1·86 years (95% CI 1·83–1·89) for males and 2·50 years (2·47–2·53) for females. As mortality from infectious diseases declined, the main contributors to Hong Kong's survival advantage were lower mortality from cardiovascular diseases for both males (TCAL difference 1·22 years, 95% CI 1·21–1·23) and females (1·19 years, 1·18–1·21), cancer for females (0·47 years, 0·45–0·48), and transport accidents for males (0·27 years, 0·27–0·28). Among high-income populations, Hong Kong recorded the lowest cardiovascular mortality and one of the lowest cancer mortalities in women. These findings were underpinned by the lowest absolute smoking-attributable mortality in high-income regions (39·7 per 100 000 in 2016, 95% CI 34·4–45·0). Reduced smoking-attributable mortality contributed to 50·5% (0·94 years, 0·93–0·95) of Hong Kong's survival advantage over males in high-income countries and 34·8% (0·87 years, 0·87–0·88) of it in females.InterpretationHong Kong's leading longevity is the result of fewer diseases of poverty while suppressing the diseases of affluence. A unique combination of economic prosperity and low levels of smoking with development contributed to this achievement. As such, it offers a framework that could be replicated through deliberate policies in developing and developed populations globally.FundingEarly Career Scheme (RGC ECS Grant #27602415), Research Grants Council, University Grants Committee of Hong Kong.
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参考资料
[1] Michael Y Ni, et al., (2021). Understanding longevity in Hong Kong: a comparative study with long-living, high-income countries. The Lancet Public Health, DOI: https://doi.org/10.1016/S2468-2667(21)00208-5
