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全球人均寿命延长,但未必更健康

Life Expectancy Rises Around the World, Study Finds
全球人均寿命延长,但未必更健康

A sharp decline in deaths from malnutrition and infectious diseases like measles and tuberculosis has caused a shift in global mortality patterns over the past 20 years, according to a report published on Thursday, with far more of the world’s population now living into old age and dying from diseases mostly associated with rich countries, like cancer and heart disease.

根据周四发布的一项报告,在过去20年间,死于营养不良及麻疹、肺结核等传染疾病的人数急剧下降,使得世界上的更多人口得以步入老年并死于癌症和心脏病等富裕国家常见的疾病,从而导致全球死亡模式出现转变。

The shift reflects improvements in sanitation, medical services and access to food throughout the developing world, as well as the success of broad public health efforts like vaccine programs. The results are striking: infant mortality declined by more than half from 1990 to 2010, and malnutrition, the No. 1 risk factor for death and years of life lost in 1990, has fallen to No. 8.

这一转变反映了发展中国家的环境卫生、医疗服务和粮食供应得到了普遍改善,同时也表明,如疫苗接种计划等覆盖面广泛的公共卫生项目也获得成功。最终的结果十分惊人:自1990年至2010年,婴儿死亡率下降了一多半,而在1990年,营养不良是造成死亡及寿命损失的首要危险因素,现在其排名已下降至第八位。
 

At the same time, chronic diseases like cancer now account for about two out of every three deaths worldwide, up from just over half in 1990. Eight million people died of cancer in 2010, 38 percent more than in 1990. Diabetes claimed 1.3 million lives in 2010, double the number in 1990.

与此同时,全球死于癌症等慢性疾病的人,占整体死亡人数的比例已由1990年的略超一半上升到现在的近三分之二。2010年,800万人死于癌症,比1990年增加了38%。而在2010年,糖尿病夺走了130万人的生命,比1990年增加了一倍。

“The growth of these rich-country diseases, like heart disease, stroke, cancer and diabetes, is in a strange way good news,” said Ezekiel Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania. “It shows that many parts of the globe have largely overcome infectious and communicable diseases as a pervasive threat, and that people on average are living longer.”

“这些富裕国家的常见疾病出现增加,比如,心脏病、中风、癌症和糖尿病等,尽管这么说很奇怪,但其实是个好消息。”宾夕法尼亚大学(University of Pennsylvania)医学伦理学和卫生政策系主任伊奇基尔·伊曼纽尔(Ezekiel Emanuel)说。“这表明,在全球很多国家,传染性和传播性疾病在很大程度上,已经不再是普遍的威胁,平均来说,人们的寿命增加了。”

In 2010, 43 percent of deaths in the world occurred at age 70 and older, compared with 33 percent of deaths in 1990, the report said. And fewer child deaths have brought up the mean age of death, which in Brazil and Paraguay jumped to 63 in 2010, up from 30 in 1970, the report said. The measure, an average of all deaths in a given year, is different from life expectancy, and is lower when large numbers of children die.

该报告称,2010年,全球死于70岁及以后的人占整体死亡人数的比例由1990年的33%上升到43%。由于儿童死亡人数减少,平均死亡年龄也提高了,在巴西和巴拉圭,该数据由1970年的30岁上升至63岁。这一指标不同于预期寿命,计算的是特定年份所有死亡人数的平均年龄,当出现大量儿童死亡时,此指标便会下降。

But while developing countries made big strides the United States stagnated. American women registered the smallest gains in life expectancy of all high-income countries’ female populations between 1990 and 2010. American women gained just under two years of life, compared with women in Cyprus, who lived 2.3 years longer and Canadian women who gained 2.4 years. The slow increase caused American women to fall to 36th place in the report’s global ranking of life expectancy, down from 22nd in 1990. Life expectancy for American women was 80.5 in 2010, up from 78.6 in 1990.

但是,尽管发展中国家取得了巨大进步,美国在这方面却出现了停滞。1980年至1990年间,在所有高收入国家的女性中,美国女性预期寿命增幅最低,增长不到两年,而塞浦路斯女性和加拿大女性的预期寿命分别增长了2.3年和2.4年。在该报告发布的全球预期寿命排名中,由于增幅缓慢,美国女性的排名从1990年的22位下降至36位。美国女性的预期寿命在1990年为78.6岁,到了2010年,上升至80.5岁。

“It’s alarming just how little progress there has been for women in the United States,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation, a health research organization financed by the Bill and Melinda Gates Foundation at the University of Washington that coordinated the report. Rising rates of obesity among American women and the legacy of smoking, a habit women formed later than men, are among the factors contributing to the stagnation, he said. American men gained in life expectancy, to 75.9 years from 71.7 in 1990.

“美国女性预期寿命的提升非常微弱,这令人担忧,”健康指标和评估研究所(Institute for Health Metrics and Evaluation)所长克里斯托弗·默里(Christopher Murray)说。这是一个由华盛顿大学(University of Washington)比尔和梅琳达·盖茨基金会(Bill and Melinda Gates Foundation)资助的健康研究组织,也是这份报告的协调机构。他说,美国女性预期寿命停滞不前的原因包括,她们当中的肥胖率不断提高,还有吸烟的习惯。女性形成抽烟的习惯晚于男性。美国男性的预期寿命,从1990年的71.7岁,增长到2010年的75.9岁。

Health experts from more than 300 institutions contributed to the report, which provided estimates of disease and mortality for populations in more than 180 countries. It was published in The Lancet, a British medical journal.

来自300多家研究机构的健康专家参与了报告的研究。这份报告发布在英国医学杂志《柳叶刀》(The Lancet)上,报告给出了世界上180多个国家的人口疾病和预期寿命的估测数据。

The World Health Organization issued a statement on Thursday saying that some of the estimates in the report differed substantially from those done by United Nations agencies, though others were similar. All comprehensive estimates of global mortality rely heavily on statistical modeling because only 34 countries — representing about 15 percent of the world’s population — produce quality cause-of-death data.

世界卫生组织(World Health Organization)在周四发表的一份声明中称,尽管这份报告中的一些估测数据与美国机构的结果类似,而其中某些却有显著差异。所有对于全球预期寿命的全面估测结果,都高度依赖于统计模型,因为只有34个国家提供高质量的死因数据,而这些国家的人口仅占世界人口的15%。

Sub-Saharan Africa was an exception to the trend. Infectious diseases, childhood illnesses and maternity-related causes of death still account for about 70 percent of the region’s disease burden, a measure of years of life lost due to premature death and to time lived less than full health. In contrast, they account for just one-third in South Asia, and less than a fifth in all other regions. Sub-Saharan Africa also lagged in mortality gains, with the average age of death there rising by fewer than 10 years from 1970 to 2010, compared with a more than 25-year increase in Latin America, Asia and North Africa.

撒哈拉以南非洲在这种趋势中是一个例外。传染疾病、儿童疾病,以及与孕产相关的死因,仍旧占到这一地区疾病负担的70%。疾病负担(disease burden)衡量的是由于早死而损失寿命的年数,以及与完全健康状态相比,因疾病而损失的寿命年数。然而,这些问题仅占南亚地区疾病负担的三分之一,在所有其他地区则少于五分之一。撒哈拉以南非洲的寿命升幅,也落于人后,这一地区的平均死亡年龄从1970年到2010年的增幅不到10岁,而在拉丁美洲、亚洲和北非,相应数字的增长则超过25岁。

Globally, AIDS was an exception to the shift of deaths from infectious to noncommunicable diseases. The epidemic is believed to have peaked, but still results in 1.5 million deaths each year.

在全球范围内,在死亡原因由传染性疾病向非传染性疾病的转变中,艾滋病是一个例外。艾滋病的影响被认为已经走过了顶峰开始下降,但每年仍然导致了150万人的死亡。

Over all, the change means people are living longer, but it also raises troubling questions. Behavior affects people’s risks of developing cancer, heart disease and diabetes, and public health experts say it is far harder to get people to change their ways than to administer a vaccine that protects children from an infectious disease like measles.

总之,这一改变意味着人们的寿命越来越长,但同时也提出了令人不安的问题。人们的行为会增加自己患上癌症、心脏病和糖尿病的风险。公共卫生专家称,让人们改善自己的行为,远比用疫苗来防止儿童患上传染病要困难。

“Adult mortality is a much harder task for the public health systems in the world,” said Colin Mathers, a senior scientist at the World Health Organization.

“对于世界上的公共卫生系统来说,提高成人的预期寿命,是一项难得多的任务,”世界卫生组织资深科学家科林·马瑟斯(Colin Mathers)说。

Tobacco use is a rising threat, especially in developing countries, and is responsible for almost six million deaths a year globally. Illnesses like diabetes are also spreading fast.

吸烟每年在全球导致了将近600万人的死亡,这是一个不断加剧的威胁,尤其是在发展中国家。糖尿病等疾病的影响范围也在迅速扩大。
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