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Țarcă V, Țarcă E, Moscalu M. Social and Economic Determinants of Life Expectancy at Birth in Eastern Europe. Healthcare (Basel) 2024; 12:1148. [PMID: 38891223 PMCID: PMC11171643 DOI: 10.3390/healthcare12111148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/26/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Life expectancy at birth is considered a parameter of the social development, health system, or economic development of a country. We aimed to investigate the effects of GDP per capita (as the economic factor), health care expenditure, the number of medical doctors (as social factors), and CO2 emissions (as the environmental factor) on life expectancy. We used panel data analysis for 13 Eastern European countries over the 2000-2020 period. After performing the analysis, we used a cross-country fixed-effects panel (GLS with SUR weights). According to our model, a one percent increase in health expenditure (as % of GDP) increases life expectancy at birth by 0.376 years, whereas each additional medical doctor per 10,000 inhabitants increases life expectancy at birth by 0.088 years on average. At the same time, each additional 10,000 USD per capita each year would increase life expectancy at birth by 1.8 years on average. If CO2 emissions increase by 1 metric ton per capita, life expectancy at birth would decrease by 0.24 years, suggesting that higher carbon emissions are capable of reducing longevity. Every European country has to make special efforts to increase the life expectancy of its inhabitants by applying economic and health policies focused on the well-being of the population.
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Affiliation(s)
- Viorel Țarcă
- Department of Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, Universității Street No. 18, 700115 Iassy, Romania; (V.Ț.); (M.M.)
| | - Elena Țarcă
- Department of Surgery II—Pediatric Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihaela Moscalu
- Department of Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, Universității Street No. 18, 700115 Iassy, Romania; (V.Ț.); (M.M.)
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Chen S, Li R. Life expectancy and emission trading scheme: a case study in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:24536-24546. [PMID: 38441734 DOI: 10.1007/s11356-024-32710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/26/2024] [Indexed: 04/07/2024]
Abstract
Life expectancy can reflect both health benefit and implementation cost of climate policy. Nevertheless, little research has quantified the relation between life expectancy and climate policy in literature. In this paper, we attempt to narrow the research gap by studying how life expectancy is related to the Chinese nationwide emission trading scheme (CNETS). To achieve this research target, a Computable General Equilibrium (CGE) model is employed to simulate the operation of the economic system and the policy shock from emission abatement. The CGE model results show that life expectancy is prolonged by GDP but shortened by emissions, and the GDP impact on life expectancy is larger than the emission impact. Climate policy has dual effects on life expectancy because it relieves both negative emission impacts and positive GDP impacts on lifespan; its net effect on life expectancy is positive. Life expectancy positively impacts GDP, and this impact is moderated by climate policy; specifically, climate policy reinforces the positive impact of life expectancy on GDP. Life expectancy minimally affects carbon emissions during climate policy implementation; in other words, it has minimal impacts on emission abatement. These findings imply that climate policy and life expectancy complement each other; the government could implement climate policy to increase lifespan or prolong life expectancy to facilitate policy implementation.
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Affiliation(s)
- Shuyang Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control (SKLESPC), School of Environment, Tsinghua University, Beijing, 100084, China.
| | - Ruijie Li
- Postdoctoral Research Station of Agricultural Bank of China, Beijing, 100005, China
- School of Environment, Postdoctoral Research Station of Tsinghua University, Beijing, 100084, China
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Nica E, Poliakova A, Popescu GH, Valaskova K, Burcea SG, Constantin ALD. The impact of financial development, health expenditure, CO2 emissions, institutional quality, and energy Mix on life expectancy in Eastern Europe: CS-ARDL and quantile regression Approaches. Heliyon 2023; 9:e21084. [PMID: 38027924 PMCID: PMC10651455 DOI: 10.1016/j.heliyon.2023.e21084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/05/2023] [Accepted: 10/15/2023] [Indexed: 12/01/2023] Open
Abstract
In recent years, the interrelationships between the environment, energy, and health have received a growing amount of attention due to their substantial impact on the health of humans. By examining what influences Eastern Europeans' longevity between 1990 and 2021, this study hopes to contribute to this field of study. Energy consumption, health expenditure, pollution, institutional quality index (IQI), financial development, and other attributes profoundly impact human health. Because of the extensive network of commerce, tourism, education, religion, and treaties connecting East European countries, tests for cross-sectional dependence (CSD) and slope heterogeneity (SH) are utilized. After verifying the CSD and SH issues, the study uses the second generation's unit root and cointegration tests. As the previous test indicates, a new panel method, the cross-sectional autoregressive distributive lag (CS-ARDL) model, is required, as conventional estimations are inappropriate. The Quantile Regression (QR) method is also applied to check robustness. This study indicated that increased health expenditure, renewable energy consumption, and IQI improves health outcomes in Eastern European nations. There was a good connection between renewable energy consumption and health benefits, the study concluded. Though financial development positively impacts life expectancy, the impact is insignificant. On the other hand, the study also shows that CO2 emissions and fossil fuel consumption decrease life expectancy. These results are consistent with those obtained using the QR method. To enhance health outcomes, it is necessary to take measures to raise health spending, increase the use of renewable energy, and foster financial development over the long term. On the other hand, Eastern European nations need to shift their attention from fossil fuels to renewable energy.
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Affiliation(s)
- Elvira Nica
- Department of Administration and Public Management, Faculty of Administration and Public Management, Bucharest University of Economic Studies, Piața Romană, 6, Romania
| | - Adela Poliakova
- Department of Economics, Faculty of Operation and Economics of Transport and Communications, University of Zilina, Zilina, Slovak Republic
| | - Gheorghe H. Popescu
- Department of Finance, Banking and Accounting, Faculty of Finance, Banking and Accounting "Dimitrie Cantemir" Christian University, Bucharest, Romania
| | - Katarina Valaskova
- Department of Economics, Faculty of Operation and Economics of Transport and Communications, University of Zilina, Zilina, Slovak Republic
| | - Stefan Gabriel Burcea
- Department of Administration and Public Management, Faculty of Administration and Public Management, Bucharest University of Economic Studies, Piața Romană, 6, Romania
| | - Andreea-Ligia Drugau Constantin
- Department of Administration and Public Management, Faculty of Administration and Public Management, Bucharest University of Economic Studies, Piața Romană, 6, Romania
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Stroisch S, Angelini V, Schnettler S, Vogt T. Population health differences in cross-border regions within the European Union and Schengen area: a protocol for a scoping review. BMJ Open 2023; 13:e068571. [PMID: 37591651 PMCID: PMC10441078 DOI: 10.1136/bmjopen-2022-068571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 07/13/2023] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Along with European integration and the harmonisation of living conditions, improvements in health have been observed over the past decades. However, sociospatial inequalities within and across member states still exist today. While drivers of these health inequalities have been widely researched on a national and regional scale, cross-border regions remain understudied. The removal of border controls within the European Union (EU) member states has facilitated economic convergence and created new opportunities, including cross-border cooperation in the healthcare systems. However, whether and how these developments have influenced the population health in the respective cross-border regions is unclear. Hence, this scoping review aims to examine the empirical literature on the changes in health outcomes over time at the population level in EU cross-border areas. Additionally, we aim to identify the type of evidence and available data sources in those studies. Finally, we will determine the research gaps in the literature. METHODS AND ANALYSIS We will follow the Joanna Briggs Institute methodology for this scoping review. The 'Population-Concept-Context' framework will be used to identify the eligibility criteria. A three-step search strategy will be conducted to find relevant studies in the databases of PubMed, Web of Science, Scopus and EBSCOhost (SocIndex). Additionally, we will search on websites of international governmental institutions for further reports and articles. The finalisation of the search is planned for August 2023. The extracted data from the scoping review will be presented in a tabular form. A narrative summary of the selected studies will accompany the tabulated results and describe how they answer the research questions. ETHICS AND DISSEMINATION We will exclusively use secondary data from available studies for our analysis. Therefore, this review does not require ethical approval. We aim to publish our findings at (inter-)national conferences and as an open-access, peer-reviewed journal article.
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Affiliation(s)
- Sophie Stroisch
- Population Research Centre, University of Groningen Faculty of Spatial Sciences, Groningen, The Netherlands
- Institute for Social Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Viola Angelini
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Sebastian Schnettler
- Institute for Social Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Tobias Vogt
- Population Research Centre, University of Groningen Faculty of Spatial Sciences, Groningen, The Netherlands
- Prasana School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Nikoloski Z, Shkolnikov VM, Mossialos E. Preventable mortality in the Russian Federation: a retrospective, regional level study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 29:100631. [PMID: 37180281 PMCID: PMC10172901 DOI: 10.1016/j.lanepe.2023.100631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 05/16/2023]
Abstract
Background Avoidable mortality, including both treatable and preventable deaths, is frequently used as an indicator of health system performance. Whilst the term treatable mortality refers to deaths that might be averted by medical interventions, preventable mortality generally reflects the impact of system-wide health policies. The concept of preventable mortality has not been evaluated extensively in the Russian Federation, particularly at the regional or sub-national (oblast) level. Methods We calculated total preventable mortality as well as individual rates for males and females in each oblast using data from the Russian Fertility and Mortality Database (RusFMD) and computed the contributions of specific preventable causes of death to the overall rates. We also evaluated the relationship between preventable mortality and its main correlates during the years 2014-2018 using panel fixed effects modelling with variables that reflected both, behavioural risk factors and access to health care. Findings Overall preventable mortality in the Russian Federation has been on a downward trend. Whilst 548 preventable deaths per 100,000 person-years were reported in the year 2000, only 301 per 100,000 person-years were reported in 2018. Whilst mortality due to cancer, cardiovascular, and alcohol-related diseases has declined (albeit unevenly) amongst both males and females, deaths resulting from complications of diabetes and human immunodeficiency virus infection have increased. Our findings also revealed significant heterogeneity in preventable mortality at the oblast level. For example, in 2018, deaths due to preventable causes were concentrated primarily in Siberia and the Far East. Smoking and the availability of nurses were identified as significant correlates of preventable mortality at the oblast level. Interpretations Efforts designed to strengthen the current health care system, notably those serving the rural and less densely populated oblasts, might reduce the rate of preventable mortality in Russia. These efforts might be coupled with an ongoing focus on programs designed to reduce smoking. Funding None.
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Affiliation(s)
- Zlatko Nikoloski
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
- Corresponding author.
| | - Vladimir M. Shkolnikov
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock 18057, Germany
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
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Megbowon ET, David OO. Information and communication technology development and health gap nexus in Africa. Front Public Health 2023; 11:1145564. [PMID: 37064667 PMCID: PMC10097944 DOI: 10.3389/fpubh.2023.1145564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/01/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Development of information and communication technology has been identified as a tool for fast and effective information gathering and dissemination, and as a means through which almost every social and economic sector (including the health sector) could achieve economic, operational, and service delivery efficiencies that can enable the realization of targeted outcomes. ICT can serve as a tool for achieving international agreements (including the Alma Ata Declaration of 1978), thereby accelerating the achievement of various global development targets. Methods Consequently, based on a sample of 38 countries from 2000 to 2018, this study investigates the effect of ICT development on the health gap, and whether the effect varies by gender and sub-region in Africa. The dependent variable (health gap) was measured as the difference between the achieved life expectancy at birth of 60 years and the Alma Ata Declaration of 1978 targeted life expectancy at birth of 60 years. The main independent variables are ICT indicators (ICT index, mobile cellular subscriptions, and internet access), while the gross domestic product (GDP), which is the measure of economic growth, healthcare expenditure, urbanization, and labor market outcome, is employed as control variables. The effect was examined using Driscoll-Kraay standard errors, feasible generalized least squares (FGLS), and panel-corrected standard error (PCSE). Results and discussion The findings of the Driscoll-Kraay standard errors estimation technique supported by those of FGLS and PCSE suggest that ICT does act as an indispensable stimulator for Africa to significantly exceed the international health target of life expectancy at birth of 60 years. It can be concluded that African leaders need to take advantage and maximize the health-enhancing potential of the internet component of ICT through relevant policies that would improve internet coverage, connectivity, and access for individuals and health institutions.
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Urashima M, Tanaka E, Ishihara H, Akutsu T. Association Between Life Expectancy at Age 60 Years Before the COVID-19 Pandemic and Excess Mortality During the Pandemic in Aging Countries. JAMA Netw Open 2022; 5:e2237528. [PMID: 36260336 PMCID: PMC9582896 DOI: 10.1001/jamanetworkopen.2022.37528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cross-sectional study investigates the association between life expectancy before COVID-19 and excess mortality during the pandemic in aging countries.
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Affiliation(s)
- Mitsuyoshi Urashima
- Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
| | - Emiri Tanaka
- Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
| | - Hiroto Ishihara
- Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
| | - Taisuke Akutsu
- Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
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Kholmatova K, Krettek A, Leon DA, Malyutina S, Cook S, Hopstock LA, Løvsletten O, Kudryavtsev AV. Obesity Prevalence and Associated Socio-Demographic Characteristics and Health Behaviors in Russia and Norway. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159428. [PMID: 35954782 PMCID: PMC9367755 DOI: 10.3390/ijerph19159428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 01/27/2023]
Abstract
Associations between obesity and socio-demographic and behavioral characteristics vary between populations. Exploring such differences should throw light on factors related to obesity. We examined associations between general obesity (GO, defined by body mass index) and abdominal obesity (AO, defined by waist-to-hip ratio) and sex, age, socio-economic characteristics (education, financial situation, marital status), smoking and alcohol consumption in women and men aged 40–69 years from the Know Your Heart study (KYH, Russia, N = 4121, 2015–2018) and the seventh Tromsø Study (Tromsø7, Norway, N = 17,646, 2015–2016). Age-standardized prevalence of GO and AO was higher in KYH compared to Tromsø7 women (36.7 vs. 22.0% and 44.2 vs. 18.4%, respectively) and similar among men (26.0 vs. 25.7% and 74.8 vs. 72.2%, respectively). The positive association of age with GO and AO was stronger in KYH vs. Tromsø7 women and for AO it was stronger in men in Tromsø7 vs. KYH. Associations between GO and socio-economic characteristics were similar in KYH and Tromsø7, except for a stronger association with living with spouse/partner in KYH men. Smoking had a positive association with AO in men in Tromsø7 and in women in both studies. Frequent drinking was negatively associated with GO and AO in Tromsø7 participants and positively associated with GO in KYH men. We found similar obesity prevalence in Russian and Norwegian men but higher obesity prevalence in Russian compared to Norwegian women. Other results suggest that the stronger association of obesity with age in Russian women is the major driver of the higher obesity prevalence among them compared to women in Norway.
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Affiliation(s)
- Kamila Kholmatova
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- International Research Competence Centre, Northern State Medical University, Troitsky Av., 51, 163069 Arkhangelsk, Russia
- Correspondence:
| | - Alexandra Krettek
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- Department of Public Health, School of Health Sciences, University of Skövde, 541 28 Skövde, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 405 30 Gothenburg, Sweden
| | - David A. Leon
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Academician M.A. Lavrentiev Av., 17, 630090 Novosibirsk, Russia;
- Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, Krasny Av., 52, 630090 Novosibirsk, Russia
| | - Sarah Cook
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
| | - Ola Løvsletten
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
| | - Alexander V. Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- International Research Competence Centre, Northern State Medical University, Troitsky Av., 51, 163069 Arkhangelsk, Russia
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Trias-Llimós S, Cook S, Eggen AE, Kudryavtsev AV, Malyutina S, Shkolnikov VM, Leon DA. Socioeconomic inequalities in physiological risk biomarkers and the role of lifestyles among Russians aged 35-69 years. Int J Equity Health 2022; 21:51. [PMID: 35428237 PMCID: PMC9013063 DOI: 10.1186/s12939-022-01650-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/17/2022] [Indexed: 12/04/2022] Open
Abstract
Background Socioeconomic inequalities in cardiovascular (CVD) health outcomes are well documented. While Russia has one of the highest levels of CVD mortality in the world, the literature on contemporary socio-economic inequalities in biomarker CVD risk factors is sparse. This paper aims to assess the extent and the direction of SEP inequalities in established physiological CVD risk biomarkers, and to explore the role of lifestyle factors in explaining SEP inequalities in physiological CVD risk biomarkers. Methods We used cross-sectional data from a general population-based survey of Russians aged 35-69 years living in two cities (n = 4540, Know Your Heart study 2015-18). Logistic models were used to assess the associations between raised physiological risk biomarkers levels (blood pressure levels, cholesterol levels, triglycerides, HbA1C, and C-reactive protein) and socioeconomic position (SEP) (education and household financial constraints) adjusting for age, obesity, smoking, alcohol and health-care seeking behavior. Results High education was negatively associated with a raised risk of blood pressure (systolic and diastolic) and C-reactive protein for both men and women. High education was positively associated with total cholesterol, with higher HDL levels among women, and with low triglycerides and HbA1c levels among men. For the remaining risk biomarkers, we found little statistical support for SEP inequalities. Adjustment for lifestyle factors, and particularly BMI and waist-hip ratio, led to a reduction in the observed SEP inequalities in raised biomarkers risk levels, especially among women. High financial constraints were weakly associated with high risk biomarkers levels, except for strong evidence for an association with C-reactive protein (men). Conclusions Notable differences in risk biomarkers inequalities were observed according to the SEP measure employed. Clear educational inequalities in raised physiological risk biomarkers levels, particularly in blood pressure and C-reactive protein were seen in Russia and are partly explained by lifestyle factors, particularly obesity among women. These findings provide evidence-based information on the need for tackling health inequalities in the Russian population, which may help to further contribute to CVD mortality decline. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01650-3.
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Deaton A, Schreyer P. GDP, wellbeing, and health: thoughts on the 2017 round of the International Comparison Program. THE REVIEW OF INCOME AND WEALTH 2022; 68:1-15. [PMID: 35655934 PMCID: PMC9159637 DOI: 10.1111/roiw.12520] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In March 2020, the International Comparison Project published its latest results, for the calendar year 2017. This round presents common-unit or purchasing-power-parity data for 176 countries on Gross Domestic Product and its components. We review a number of important issues, what is new, what is not new, and what the new data can and cannot do. Of great importance is the lack of news, that the results are broadly in line with earlier results from 2011. We consider the relationship between national accounts measures and health, particularly in light of the COVID-19 epidemic which may reduce global inequality, even as it increases inequality within countries. We emphasize things that GDP cannot do, some familiar-like its silence on distribution-and some less familiar-including its increasing detachment from national material wellbeing in a globalized world where international transfers of capital and property rights can have enormous effects on GDP, such as the 26 percent increase in Ireland's GDP in 2015.
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Affiliation(s)
- Angus Deaton
- Princeton University, University of Southern California, and NBER
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Hubacek JA, Nikitin Y, Ragino Y, Stakhneva E, Pikhart H, Peasey A, Holmes MV, Stefler D, Ryabikov A, Verevkin E, Bobak M, Malyutina S. Longitudinal trajectories of blood lipid levels in an ageing population sample of Russian Western-Siberian urban population. PLoS One 2021; 16:e0260229. [PMID: 34855783 PMCID: PMC8638938 DOI: 10.1371/journal.pone.0260229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/04/2021] [Indexed: 11/18/2022] Open
Abstract
This study investigated 12-year blood lipid trajectories and whether these trajectories are modified by smoking and lipid lowering treatment in older Russians. To do so, we analysed data on 9,218 Russian West-Siberian Caucasians aged 45-69 years at baseline participating in the international HAPIEE cohort study. Mixed-effect multilevel models were used to estimate individual level lipid trajectories across the baseline and two follow-up examinations (16,445 separate measurements over 12 years). In all age groups, we observed a reduction in serum total cholesterol (TC), LDL-C and non-HDL-C over time even after adjusting for sex, statin treatment, hypertension, diabetes, social factors and mortality (P<0.01). In contrast, serum triglyceride (TG) values increased over time in younger age groups, reached a plateau and decreased in older age groups (> 60 years at baseline). In smokers, TC, LDL-C, non-HDL-C and TG decreased less markedly than in non-smokers, while HDL-C decreased more rapidly while the LDL-C/HDL-C ratio increased. In subjects treated with lipid-lowering drugs, TC, LDL-C and non-HDL-C decreased more markedly and HDL-C less markedly than in untreated subjects while TG and LDL-C/HDL-C remained stable or increased in treatment naïve subjects. We conclude, that in this ageing population we observed marked changes in blood lipids over a 12 year follow up, with decreasing trajectories of TC, LDL-C and non-HDL-C and mixed trajectories of TG. The findings suggest that monitoring of age-related trajectories in blood lipids may improve prediction of CVD risk beyond single measurements.
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Affiliation(s)
- Jaroslav A. Hubacek
- Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- 3 Department on Internal Medicine, 1 Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Yuri Nikitin
- Research Institute of Internal and Preventive Medicine–Branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
| | - Yulia Ragino
- Research Institute of Internal and Preventive Medicine–Branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
| | - Ekaterina Stakhneva
- Research Institute of Internal and Preventive Medicine–Branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Anne Peasey
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Michael V. Holmes
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Andrey Ryabikov
- Research Institute of Internal and Preventive Medicine–Branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
| | - Eugeny Verevkin
- Research Institute of Internal and Preventive Medicine–Branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine–Branch of Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
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Shartova N, Tikunov V, Chereshnya O. Health disparities in Russia at the regional and global scales. Int J Equity Health 2021; 20:163. [PMID: 34256759 PMCID: PMC8276545 DOI: 10.1186/s12939-021-01502-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/28/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The capacity for health comparisons, including the accurate comparison of indicators, is necessary for a comprehensive evaluation of well-being in places where people live. An important issue is the assessment of within-country heterogeneity for geographically extensive countries. The aim of this study was to assess the spatial and temporal changes in health status in Russia and to compare these regional changes with global trends. METHODS The index, which considers the infant mortality rate and the male and female life expectancy at birth, was used for this purpose. Homogeneous territorial groups were identified using principal component analysis and multivariate ranking procedures. Trend analysis of individual indicators included in the index was also performed to assess the changes over the past 20 years (1990-2017). RESULTS The study indicated a trend towards convergence in health indicators worldwide, which is largely due to changes in infant mortality. It also revealed that the trend of increasing life expectancy in many regions of Russia is not statistically significant. Significant interregional heterogeneity of health status in Russia was identified according to the application of typological ranking. The regions were characterized by similar index values until the mid-1990s. CONCLUSIONS The strong spatial inequality in health of population was found in Russia. While many regions of Russia were comparable to the countries in the high-income group in terms of GDP, the progress in health was less pronounced. Perhaps this can be explained by intraregional inequality, expressed by significant fluctuations in income levels. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Natalia Shartova
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991, Russia.
| | - Vladimir Tikunov
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Olga Chereshnya
- Faculty of Geography, Lomonosov Moscow State University, Moscow, 119991, Russia
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14
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Socio-demographic, behavioural and psycho-social factors associated with depression in two Russian cities. J Affect Disord 2021; 290:202-210. [PMID: 34004402 PMCID: PMC8626563 DOI: 10.1016/j.jad.2021.04.093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 01/11/2021] [Accepted: 04/25/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Russia has a high burden of suicide and alcohol-attributable mortality. However there have been few studies of the epidemiology of depression. METHODS The study population was 5077 men and women aged 35-69 years from a cross-sectional population based survey in the cities of Arkhangelsk and Novosibirsk (2015-17). Moderate depression was defined as Patient Health Questionnaire-9 (PHQ-9) score≥10. Risk factors considered were socio-demographic factors (age, sex, marital status, living alone, education, employment status, financial constraints); health behaviours (smoking, alcohol use) and psycho-social factors (life events and social support). RESULTS After mutual adjustment for all other factors, there was evidence that PHQ-9≥10 was associated with sex (higher in women), financial constraints, employment status, being a non-drinker, problem drinking, smoking, not having enough people to confide in and the number of life events in the past 6 months. Employment status was more strongly associated in men (OR 1.84 (95%CI 1.17, 2.88)) than women (OR 1.15 95% CI 0.86, 1.55). The effect size was particularly striking for financial constraints (odd ratio over 3 times higher in those with not enough money for food and clothes compared to no financial constraints), problem drinking (OR 1.72 (1.12, 2.65) among drinkers with CAGE score of 2 and 2.25 (95% CI 1.42, 3.57) in those with score ≥3 compared to zero) and life events (85% higher odds in those experiencing one life event and over 4 times higher odds in those experiencing 3 or more life events) all of which demonstrated a dose-response with PHQ-9>=10. LIMITATIONS The study was cross-sectional in nature therefore temporal relationships could not be assessed. CONCLUSIONS We have identified here a range of risk factors for depression among the Russian general population consistent with findings from other populations. The strikingly strong association with financial constraints indicates the importance of social inequality for the burden of depression.
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KHAFAIE MORTEZAABDULLATIF, MALEHI AMALSAKI, RAHIM FAKHER. The association between various indicators of hospital capacity, age category, and the number of screening tests performed with case fatality rate and recovery rate during the COVID-19 disease pandemic. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E261-E269. [PMID: 34604564 PMCID: PMC8451361 DOI: 10.15167/2421-4248/jpmh2021.62.2.1569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The COVID-19-related deaths are growing rapidly around the world, especially in Europe and the United States. PURPOSE In this study we attempt to measure the association of these variables with case fatality rate (CFR) and recovery rate (RR) using up-to-date data from around the world. METHODS Data were collected from eight global databases. According to the raw data of countries, the CFR and RR and their relationship with different predictors was compared for countries with 1,000 or more cases of COVID-19 confirmed cases. RESULTS There were no significant correlation between the CFR and number of hospital beds per 1,000 people, proportion of population aged 65 and older ages, and the number of computed tomography per one million inhabitants. Furthermore, based on the continents-based subgroup univariate regression analysis, the population (R2 = 0.37, P = 0.047), GPD (R2 = 0.80, P < 0.001), number of ICU Beds per 100,000 people (R2 = 0.93, P = 0.04), and number of CT per one million inhabitants (R2 = 0.78, P = 0.04) were significantly correlated with CFR in America. Moreover, the income-based subgroups analysis showed that the gross domestic product (R2 = 0.30, P = 0.001), number of ICU Beds per 100,000 people (R2 = 0.23, P = 0.008), and the number of ventilator (R2 = 0.46, P = 0.01) had significant correlation with CFR in high-income countries. CONCLUSIONS The level of country's preparedness, testing capacity, and health care system capacities also are among the important predictors of both COVID-19 associated mortality and recovery. Thus, providing up-to-date information on the main predictors of COVID-19 associated mortality and recovery will hopefully improve various countries hospital resource allocation, testing capacities, and level of preparedness.
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Affiliation(s)
- MORTEZA ABDULLATIF KHAFAIE
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - AMAL SAKI MALEHI
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - FAKHER RAHIM
- Research Center of Thalassemia & Hemoglobinopathy, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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16
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Kontsevaya AV, Doludin YV, Khudyakov MB, Drapkina OM. Regional Characteristics of Hospital Admissions and Outpatients Visits with Arterial Hypertension from the Point of the WHO Concept of Ambulatory Care Sensitive Conditions. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2020. [DOI: 10.20996/1819-6446-2020-12-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To analyze hospital admission and ambulatory care of the patients with arterial hypertension (AH) in federal districts and regions from the perspective of the WHO concept of diseases, which can be treated in ambulatory settings (ambulatory care sensitive conditions, ACSC).Material and methods. For analysis we used data from annual forms of federal statistical monitoring (12 and 14), which includes data on hospital admissions with hypertension in federal districts and separate regions in 2017. Hypertension included diseases characterized by raised blood pressure, ICD10: I10-I13.Results. We performed the analysis of 12 and 14 forms per districts and regions of the Russian Federation. Regions with increased hospitalization rates and an increased ratio of the hospitalizations to number to outpatients visits were identified. High variability of these indicators was observed both among both between regions and federal districts. The values of the ratio indicator vary from 0.0131 in the Nizhny Novgorod Region to 0.0234 in the Chechen Republic. The average value of the ratio in the federal district varies from 0.032 in the Volga Federal District to 0.119 in the North Caucasus Federal District. In the North Caucasus and Far East Federal District the value of the indicator is significantly higher than in other districts.Conclusion. Assessing diseases which can be treated in ambulatory setting scan be one of the tools for evaluating the quality of medical care in primary care facilities. However, before including ACSC as an indicator of the quality of health care delivery, a deeper understanding of the reasons that can impact its rates is required.
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Affiliation(s)
- A. V. Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - Yu. V. Doludin
- National Medical Research Center for Therapy and Preventive Medicine
| | - M. B. Khudyakov
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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17
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Trias-Llimós S, Pennells L, Tverdal A, Kudryavtsev AV, Malyutina S, Hopstock LA, Iakunchykova O, Nikitin Y, Magnus P, Kaptoge S, Di Angelantonio E, Leon DA. Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway. Sci Rep 2020; 10:20796. [PMID: 33247203 PMCID: PMC7695740 DOI: 10.1038/s41598-020-77877-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 11/17/2020] [Indexed: 02/02/2023] Open
Abstract
Surprisingly few attempts have been made to quantify the simultaneous contribution of well-established risk factors to CVD mortality differences between countries. We aimed to develop and critically appraise an approach to doing so, applying it to the substantial CVD mortality gap between Russia and Norway using survey data in three cities and mortality risks from the Emerging Risk Factor Collaboration. We estimated the absolute and relative differences in CVD mortality at ages 40-69 years between countries attributable to the risk factors, under the counterfactual that the age- and sex-specific risk factor profile in Russia was as in Norway, and vice-versa. Under the counterfactual that Russia had the Norwegian risk factor profile, the absolute age-standardized CVD mortality gap would decline by 33.3% (95% CI 25.1-40.1) among men and 22.1% (10.4-31.3) among women. In relative terms, the mortality rate ratio (Russia/Norway) would decline from 9-10 to 7-8. Under the counterfactual that Norway had the Russian risk factor profile, the mortality gap reduced less. Well-established CVD risk factors account for a third of the male and around a quarter of the female CVD mortality gap between Russia and Norway. However, these estimates are based on widely held epidemiological assumptions that deserve further scrutiny.
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Affiliation(s)
- Sergi Trias-Llimós
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Lisa Pennells
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Aage Tverdal
- Centre for Fertility and Health, Norwegian Insitute of Public Health, Oslo, Norway
| | - Alexander V Kudryavtsev
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine-Branch of IC&G, SB RAS, Novosibirsk, Russia
- Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk, Russia
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Olena Iakunchykova
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Yuri Nikitin
- Research Institute of Internal and Preventive Medicine-Branch of IC&G, SB RAS, Novosibirsk, Russia
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Insitute of Public Health, Oslo, Norway
| | - Stephen Kaptoge
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - David A Leon
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- International Laboratory for Population and Health, National Research University, Higher School of Economics, Moscow, Russian Federation
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18
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Cook S, Kudryavtsev AV, Bobrova N, Saburova L, Denisova D, Malyutina S, Lewis G, Leon DA. Prevalence of symptoms, ever having received a diagnosis and treatment of depression and anxiety, and associations with health service use amongst the general population in two Russian cities. BMC Psychiatry 2020; 20:537. [PMID: 33183249 PMCID: PMC7663865 DOI: 10.1186/s12888-020-02938-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the burden of common mental disorders in Russia despite high levels of suicide and alcohol-related mortality. Here we investigated levels of symptoms, self-reports of ever having received a diagnosis and treatment of anxiety and depression in two Russian cities. METHODS The study population was men and women aged 35-69 years old participating in cross-sectional population-based studies in the cities of Arkhangelsk and Novosibirsk (2015-18). Participants completed an interview which included the PHQ-9 and GAD-7 scales, questions on whether participants had ever received a diagnosis of depression or anxiety, and health service use in the past year. Participants also reported current medication use and medications were coded in line with the WHO anatomical therapeutic classification (ATC). Depression was defined as PHQ-9 ≥ 10 and Anxiety as GAD-7 ≥ 10. RESULTS Age-standardised prevalence of PHQ-9 ≥ 10 was 10.7% in women and 5.4% in men (GAD-7 ≥ 10 6.2% in women; 3.0% in men). Among those with PHQ-9 ≥ 10 17% reported ever having been diagnosed with depression (equivalent finding for anxiety 29%). Only 1.5% of those with PHQ-9 ≥ 10 reported using anti-depressants and 0.6% of those with GAD-7 ≥ 10 reported using anxiolytics. No men with PHQ-9 ≥ 10 and/or GAD-7 ≥ 10 reported use of anti-depressants or anxiolytics. Use of health services increased with increasing severity of both depression and anxiety. CONCLUSION There was a large gap between symptoms and reporting of past diagnosis and treatment of common mental disorders in two Russian cities. Interventions aimed at improving mental health literacy and reducing stigma could be of benefit in closing this substantial treatment gap.
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Affiliation(s)
- Sarah Cook
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway. .,Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Alexander V. Kudryavtsev
- grid.10919.300000000122595234Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway ,grid.412254.40000 0001 0339 7822Northern State Medical University, Arkhangelsk, Russian Federation
| | - Natalia Bobrova
- grid.8991.90000 0004 0425 469XFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Lyudmila Saburova
- grid.426536.00000 0004 1760 306XInstitute of Philosophy and Law, Ural Branch of the Russian Academy of Sciences, Ekaterinburg, Russian Federation
| | - Diana Denisova
- grid.415877.80000 0001 2254 1834Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Sofia Malyutina
- grid.415877.80000 0001 2254 1834Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation ,grid.445341.30000 0004 0467 3915Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, Russian Federation
| | - Glyn Lewis
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, London, UK
| | - David A. Leon
- grid.10919.300000000122595234Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway ,grid.8991.90000 0004 0425 469XFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK ,grid.410682.90000 0004 0578 2005International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation
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19
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Neufeld M, Bobrova A, Davletov K, Štelemėkas M, Stoppel R, Ferreira-Borges C, Breda J, Rehm J. Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects. Drug Alcohol Rev 2020; 40:350-367. [PMID: 33155370 PMCID: PMC7936953 DOI: 10.1111/dar.13204] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/19/2020] [Accepted: 09/20/2020] [Indexed: 01/06/2023]
Abstract
Issues. The last Soviet anti-alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign’s policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign’s end, the region faces diverse challenges in relation to alcohol. Approach. The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments. Key Findings. Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol-control measures. The so-called three ‘best buys’ put forward by the World Health Organization to reduce alcohol-attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries. Implications. In recent years, evidence-based alcohol policies have been actively implemented as a response to the enormous alcohol-attributable burden in many of the countries, although there is big variance across and within different jurisdictions. Conclusion. Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.
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Affiliation(s)
- Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia.,Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Anastacia Bobrova
- Institute of Economics, National Academy of Sciences, Minsk, Belarus
| | - Kairat Davletov
- Health Research Institute, Faculty of Medicine, Al-Farabi Kazakh National University Almaty, Almaty, Kazakhstan
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Relika Stoppel
- Department of Economics, University of Potsdam, Potsdam, Germany
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia
| | - João Breda
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia
| | - Jürgen Rehm
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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20
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Canudas-Romo V, Adair T, Mazzuco S. Reflection on modern methods: cause of death decomposition of cohort survival comparisons. Int J Epidemiol 2020; 49:1712-1718. [PMID: 32011680 DOI: 10.1093/ije/dyz276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/06/2019] [Accepted: 12/18/2019] [Indexed: 11/13/2022] Open
Abstract
Life expectancy is most commonly measured for a period (corresponding to mortality within a given year) or for a specific birth cohort. Although widely used, period and cohort life expectancy have limitations as their time-trends often show disparities and can mask the historical mortality experience of all cohorts present at a given time. The truncated cross-sectional average length of life, or TCAL, is a period measure including all available cohort mortality information, irrespective of whether all cohort members have died. It is particularly useful for comparing cohort mortality between populations. This study extends TCAL by disentangling causes of death contributions. The strength of the approach is that it allows identification of mortality differences in cohorts with members still alive, as well as identification of which ages and causes of death contribute to mortality differentials between populations. Application of the method to Japan shows that over the period 1950-2014 a major contributor to TCAL differences with other high-longevity countries was its lower cardiovascular disease mortality.
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Affiliation(s)
- Vladimir Canudas-Romo
- School of Demography, College of Arts and Social Sciences, The Australian National University, Acton, ACT 2601, Australia
| | - Tim Adair
- Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
| | - Stefano Mazzuco
- Department of Statistical Sciences, University of Padova, Padova, Italy
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21
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Barnett A. All The Same? On a Certain Pattern in Cross-National Death Risk. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:1831-1843. [PMID: 32602166 DOI: 10.1111/risa.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 12/04/2019] [Accepted: 05/14/2020] [Indexed: 06/11/2023]
Abstract
This article considers whether a nation that fares relatively well (or badly) on a particular dimension of mortality risk tends also to do so on others. Working with 2016 data from the Global Burden of Disease (GBD) Study, we focus on six causes of premature death: transport accidents, other accidents, homicide, early-childhood diseases, and both communicable and noncommunicable diseases beyond early childhood. We consider data from all 26 nations that had populations of at least 50 million in 2016, as well as 15 clusters of smaller nations that are similar in longevity (e.g., Scandinavia). We use an analytic method that facilitates useful comparisons across nations, for it recognizes that some potential death risks can be underestimated because citizens die sooner from other causes. We estimate reductions in lifespan from each of the six causes relative to natural lifespan as defined by GBD. It emerges that, for all 15 pairings among the six causes, these reductions are positively correlated. We introduce metrics to summarize a nation's overall "safety status," and find that losses of longevity because of premature deaths are nearly three decades fewer in the safest countries than in the least safe ones. Turning to possible explanations for the cross-national differences, we find a strong association between a nation's safety status and both its economic wherewithal as indicated by the 2016 GDP per capita (adjusted for purchasing power parity) and its income inequality as reflected by its Gini coefficient.
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Affiliation(s)
- Arnold Barnett
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA
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22
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Lin FL, Wang MC. Longevity and Economic Growth in China and India Using a Newly Developed Bootstrap ARDL Model. Front Public Health 2020; 8:291. [PMID: 32850569 PMCID: PMC7427201 DOI: 10.3389/fpubh.2020.00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 06/02/2020] [Indexed: 11/13/2022] Open
Abstract
In this study, we use a recently developed Bootstrap ARDL model to examine the influence of longevity (life expectancy after giving birth) and alcohol consumption on economic progression (GDP) in both China and India during the years between 1992 and 2015. Empirical results have shown an extended link across economic development, longevity, and alcohol use in both China and India. The Granger causality test, derived from the Bootstrap ARDL model, demonstrates a unidirectional relationship between economic growth and longevity in China. However, a bidirectional causality exists between longevity and alcohol use in India. Results have important implications for Indian and Chinese governments' public health policies, focused on alcohol consumption reduction specifically, and population health generally.
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Affiliation(s)
- Feng Li Lin
- Department of Accounting, Chaoyang University of Technology, Taichung, Taiwan
| | - Mei-Chih Wang
- Department of Finance, College of Management, Providence University, Taichung, Taiwan
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23
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Neufeld M, Ferreira-Borges C, Gil A, Manthey J, Rehm J. Alcohol policy has saved lives in the Russian Federation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 80:102636. [PMID: 32417670 DOI: 10.1016/j.drugpo.2019.102636] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/15/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Abstract
Alcohol use has been determined to be one of the main risk factors of, and contributors to, premature mortality in Russia, but no formal analysis of the impact of alcohol control policies has been undertaken so far. The present contribution is a commentary on a policy impact study undertaken by the World Health Organization on the effects of alcohol control measures on mortality and life expectancy in the Russian Federation. As part of the case study, all alcohol control policies in Russia from 1990 to 2018 were examined, and periods with differing policy intensity were distinguished based on the known effectiveness of different measures. Trends in all-cause mortality during these periods, and the shifts in trends between periods, were analysed using interrupted-time series methodology. As predicted, the intensity of alcohol control policies strongly impacted all-cause mortality. The experience of the Russian Federation in reducing the burden of disease caused by alcohol is a strong argument that effective alcohol policies are essential for improving the prospects for long and healthy lives.
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Affiliation(s)
- Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation; Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON M5S 2S1, Canada.
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - Artyom Gil
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, 119992 Moscow, Russian Federation
| | - Jakob Manthey
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
| | - Jürgen Rehm
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON M5S 2S1, Canada; Institute of Medical Science (IMS), University of Toronto, Room 2374, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON M5T 3M7, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada; Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON M5T 1R8, Canada; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya Street, 8, b. 2, 119992 Moscow, Russian Federation
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24
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Petersen J, Kontsevaya A, McKee M, Richardson E, Cook S, Malyutina S, Kudryavtsev AV, Leon DA. Primary care use and cardiovascular disease risk in Russian 40-69 year olds: a cross-sectional study. J Epidemiol Community Health 2020; 74:692-967. [PMID: 32366586 PMCID: PMC7577087 DOI: 10.1136/jech-2019-213549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/04/2020] [Accepted: 04/14/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The Russian Federation has very high cardiovascular disease (CVD) mortality rates compared with countries of similar economic development. This cross-sectional study compares the characteristics of CVD-free participants with and without recent primary care contact to ascertain their CVD risk and health status. METHODS A total of 2774 participants aged 40-69 years with no self-reported CVD history were selected from a population-based study conducted in Arkhangelsk and Novosibirsk, Russian Federation, 2015-2018. A range of co-variates related to socio-demographics, health and health behaviours were included. Recent primary care contact was defined as seeing primary care doctor in the past year or having attended a general health check under the 2013 Dispansarisation programme. RESULTS The proportion with no recent primary care contact was 32.3% (95% CI 29.7% to 35.0%) in males, 16.3% (95% CI 14.6% to 18.2%) in females, and 23.1% (95% CI 21.6% to 24.7%) overall. In gender-specific age-adjusted analyses, no recent contact was also associated with low education, smoking, very good to excellent self-rated health, no chest pain, CVD 10-year SCORE risk 5+%, absence of hypertension control, absence of hypertension awareness and absence of care-intensive conditions. Among those with no contact: 37% current smokers, 34% with 5+% 10-year CVD risk, 32% untreated hypertension, 20% non-anginal chest pain, 18% problem drinkers, 14% uncontrolled hypertension and 9% Grade 1-2 angina. The proportion without general health check attendance was 54.6%. CONCLUSION Primary care and community interventions would be required to proactively reach sections of 40-69 year olds currently not in contact with primary care services to reduce their CVD risk through diagnosis, treatment, lifestyle recommendations and active follow-up.
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Affiliation(s)
- Jakob Petersen
- London School of Hygiene and Tropical Medicine, London, UK .,UCL, London, UK
| | - Anna Kontsevaya
- National Research Centre for Preventive Medicine, Moskva, Russian Federation
| | - Martin McKee
- Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Erica Richardson
- ECOHOST, London School of Hygiene and Tropical Medicine, London, UK
| | - Sarah Cook
- Department of Community Medicine, UiT Arctic University of Norway, Tromso, Norway
| | - Sofia Malyutina
- Institute of Internal Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation.,Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | | | - David A Leon
- London School of Hygiene and Tropical Medicine, London, UK
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25
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Timonin S, Jasilionis D, Shkolnikov VM, Andreev E. New perspective on geographical mortality divide in Russia: a district-level cross-sectional analysis, 2008-2012. J Epidemiol Community Health 2020; 74:144-150. [PMID: 31676666 PMCID: PMC6993025 DOI: 10.1136/jech-2019-213239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/05/2019] [Accepted: 10/07/2019] [Indexed: 12/02/2022]
Abstract
BACKGROUND Prior studies on spatial inequalities in mortality in Russia were restricted to the highest level of administrative division, ignoring variations within the regions. Using mortality data for 2239 districts, this study is the first analysis to capture the scale of the mortality divide at a more detailed level. METHODS Age-standardised death rates are calculated using aggregated deaths for 2008-2012 and population exposures from the 2010 census. Inequality indices and decomposition are applied to quantify both the total mortality disparities across the districts and the contributions of the variations between and within regions. RESULTS Regional variations in mortality mask one-third (males) and one-half (females) of the inequalities observed at the district level. A comparison of the 5% of individuals residing in the districts with the highest and the lowest mortality shows a gap of 15.5 years for males and 10.3 years for females. The lowest life expectancy levels are in the shrinking areas of the Far East and Northwest of Russia. The highest life expectancy clusters are in the intercity districts of Moscow and Saint Petersburg, and in several science cities. Life expectancy in these best-practice districts is close to the national averages of Poland and Estonia, but is still substantially below the averages in Western countries. CONCLUSION The large between-regional and within-regional disparities suggest that national-level mortality could be lowered if these disparities are reduced by improving health in the laggard areas. This can be achieved by introducing policies that promote health convergence both within and between the Russian regions.
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Affiliation(s)
- Sergey Timonin
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russia
| | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Vladimir M Shkolnikov
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russia
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Evgeny Andreev
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russia
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26
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Vlassov V. Russia needs to look beyond longevity. LANCET PUBLIC HEALTH 2019; 4:e169-e170. [PMID: 30954136 DOI: 10.1016/s2468-2667(19)30043-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Vasiliy Vlassov
- Centre for Health Policy, National Research University Higher School of Economics, Moscow 101000.
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