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Dying too young: Deaths among middle-aged adults reversing life expectancy trends过早死亡：中年人死亡逆转预期寿命的趋势 By Erika Edwards / November 27 , 2019 剪辑：BM ︱翻译：Ray︱校对：Sally An increasing number of Americans are dying in the prime of their lives, a trend not observed in other wealthy nations, according to research published Tuesday in the Journal of the American Medical Association.
美国医学会杂志周二发表的一项研究显示，越来越多的美国人在处于壮年时去世，这是其他富裕国家所没有的趋势。These "excess deaths" — that is, people who die years and even decades before they're expected to — tend to be clustered in the nation's Rust Belt, where economies once boomed with a thriving steel industry, but have been in decline since the 1970s.这些是“过早死亡”——也就是说，这些是比预期寿命早几年甚至几十年死亡的人——往往聚集在美国的“铁锈地带”，那里的经济曾经伴随着蓬勃发展的钢铁工业而繁荣，但自1970年代以来一直在走下坡路。"That's when the U.S. began losing pace with other countries," said Dr. Steven Woolf, lead author of the new report and the director emeritus of the Center on Society and Health at Virginia Commonwealth University.这份新报告的主要作者、弗吉尼亚联邦大学社会与健康中心名誉主任史蒂文·伍尔夫博士说：“那个时候开始美国和其他国家的步伐不同步了。”。Woolf's study analyzed nearly 60 years of data, from 1959 through 2017, collected by the Centers for Disease Control and Prevention.伍尔夫的研究分析了疾病预防控制中心从1959年到2017年近60年的数据。Life expectancy in America increased steadily from the late 1950s through 2014, when it peaked at 78.9 years. It then declined for the next three years, falling to 78.6 years in 2017.从20世纪50年代末到2014年，美国的预期寿命稳步增长，当时的峰值为78.9岁。随后的三年里，该指数下降，2017年降至78.6岁。Researchers attribute that downturn to a growing number of people dying well before they should, between the ages of 25 and 64.研究人员将这种衰退归因于越来越多的人在25到64岁之间死于意外。Major causes of death in this age group are from drug overdoses, particularly opioids, alcohol and suicides. Together, these are often referred to as "deaths of despair."这一年龄组的主要死因是毒品过量，特别是鸦片类、酗酒和自杀。归纳到一起，这些通常被称为“绝望之死”。Fatal drug overdoses increased significantly in the past two decades, most notably among people ages 55 to 64. The study found that overdose death rates rose from 2.3 deaths per 100,000 people in that age group in 1999, to 23.5 deaths per 100,000 people in 2017 — an increase of more than 900 percent.在过去20年中，因毒品过量导致的死亡显著增加，尤其是在55至64岁的人群中。研究发现，该年龄组的因毒品过量而导致的死亡率从1999年的每10万人有2.3人、上升到2017年的每10万人有23.5人，增幅超过900%。But midlife mortality rates have also increased for 35 other causes of death, especially those related to chronic health problems such as diabetes, obesity and high blood pressure. The wide range of causes of death suggests that the root of the problem is deep and complicated.但其他35种死因的中年死亡率也有所上升，特别是那些与糖尿病、肥胖和高血压等慢性健康问题有关的死因。广泛的死因表明，问题的根源是深刻和复杂的。The largest increases in excess deaths for middle-aged adults were found in the Ohio Valley region, with one-third of the country's deaths reported in just four states: Kentucky, Indiana, Ohio and Pennsylvania.中年人死亡人数增加最多的是俄亥俄州河谷地区，该国死亡人数的三分之一都出现在肯塔基州、印第安纳州、俄亥俄州和宾夕法尼亚州。The study authors say that the economic downturns that began in those states during the 1970s and the 1980s fueled chronic stress among their citizens, and are now manifested in growing midlife death rates.这项研究的作者说，这些州在上世纪70年代和80年代开始的经济衰退，使那里的居民长期受到压力，现在表现为中年死亡率的上升。"If you’re trying to make ends meet, you’re less likely to go to the doctor. You may not do a good job taking care of your diabetes or heart disease," Woolf said. "Also, you may be more likely to adopt unhealthy coping behaviors. You may turn to drugs as access to opioids becomes more prevalent as it did in the 1990s."“如果你想维持生计，就不太可能去看医生。你可能不能很好地照顾你的糖尿病或心脏病，”伍尔夫说，“此外，你可能更容易采取不健康的应对行为。比如上世纪90年代，随着鸦片类药物的使用越来越普遍，你可能会转向毒品。”Although men overall have higher death rates in this age group, women are catching up in certain areas. Between 1999 and 2017, the rate of death from alcoholic liver disease was 3.4 times higher in middle-aged women than men. Women also outpaced men in deadly drug overdoses.虽然这个年龄组的男性总的死亡率较高，但女性在某些方面正在赶上。1999年至2017年间，中年女性酒精性肝病死亡率是男性的3.4倍。在毒品过量导致死亡方面，女性也超过男性。The trends were noted across all races and ethnicities, including African American populations that have experienced disproportionately high death rates relative to whites for generations.这一趋势涉及到了所有种族和人种，包括非洲裔美国人，他们几代以来都经历了与白人相比过高的死亡率。"We, in the fields of medicine and public health, have been working very hard to try to narrow the black/white mortality gap. And for some years, we were making really good progress," Woolf said. "But now this trend has touched the African American community and that decline in mortality has stopped and reversed itself."“我们在医疗和公共卫生领域一直在努力缩小黑人和白人之间的死亡率差距。几年来，我们取得了长足的进步，”伍尔夫说。“但现在这一趋势已经影响到非洲裔美国人社区，死亡率的下降已经停止并开始逆转。”"This is quite tragic because it's reversing years of progress in lowering those rates," he added.“这相当悲惨，因为它正在逆转多年来在降低死亡率方面取得的进展，”他补充说。An editorial that accompanied the new research pointed out an emerging health problem that may serve as a warning for future mortality trends: vaping.伴随着这项新研究出现的一篇社论指出了一个新出现的健康问题，它可以作为今后死亡率趋势的一个警告，那就是：吸电子烟。"Resolving the crisis represented by a new unexplained pulmonary illness linked to use of noncombustible e-cigarettes is an immediate priority," the editorial read, "especially given substantial increases in the prevalence of youth vaping."社论写道：“解决由一种新的不明原因的肺部疾病所代表的危机是一个当务之急，那就是使用不燃烧的电子烟，特别是考虑到年轻人吸电子烟的流行率大幅上升。”One of the authors of the editorial, Dr. Howard Koh of the Harvard T. H. Chan School of Public Health, told NBC News the 2,290 vaping-related illnesses reported nationwide should serve as a "call to action" for strict regulation of electronic cigarettes. At least 48 people have died from EVALI, short for e-cigarette or vaping associated lung injury.这篇社论的作者之一，哈佛陈冯富珍公共卫生学院的霍华德.柯博士告诉全国广播公司新闻台，国内报道的2290例与吸电子烟有关的疾病应该作为对电子烟严格监管的“行动号召”。至少已有48人死于EVALI，这是电子烟或电子烟相关肺损伤的缩写。"If stresses lead people to take up smoking," Woolf said, "we’ve got a much bigger problem on our hands."“如果压力导致人们开始吸烟，”伍尔夫说，“我们就会面临更大的问题。”
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