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Anbari K, Sicard P, Omidi Khaniabadi Y, Raja Naqvi H, Rashidi R. Assessing the effect of COVID-19 pandemic on air quality change and human health outcomes in a capital city, southwestern Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1716-1727. [PMID: 36099327 DOI: 10.1080/09603123.2022.2120967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
The aimsof this study were to assess the spatial variation of PM2.5, NO2, and O3 between 2019 (before) and 2020 (during COVID-19 pandemic); and calculation the health outcomes of exposure to these pollutants. The daily PM2.5, NO2, and O3 concentrations were applied to assess health effects by relative risk, and baseline incidence. The annual PM2.5 and NO2 mean concentrations exceeded the WHO guideline values, while O3 did not exceed. The restrictive measures associated to COVID-19 led to reduction at the annual means of PM2.5 and NO2 by -25.5% and -23.1%, respectively, while the annual mean of O3 increased by +7.9%. The number of M-CVD and M-RD (-25.6%, -26.1%) related to PM2.5 exposure, and HA-COPD and HA-RD >65 years old (-21% and -3.84%) related to NO2 exposure were reduced in 2020, and O3 exposure-related M-CVD (+30.1%) and HA-RD >65 years old (+23.4%) increased compared to the previous year 2019.
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Affiliation(s)
- Khatereh Anbari
- Social Determinants of Health Research Center, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Yusef Omidi Khaniabadi
- Occupational and Environmental Health Research Center, Petroleum Industry Health Organization (PIHO), Ahvaz, Iran
| | - Hasan Raja Naqvi
- Department of Geography, Faculty of Natural Sciences, Jamia Millia Islamia, New Delhi, India
| | - Rajab Rashidi
- Department of Occupational Health, Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
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Gorasso V, Morgado JN, Charalampous P, Pires SM, Haagsma JA, Santos JV, Idavain J, Ngwa CH, Noguer I, Padron-Monedero A, Sarmiento R, Pinheiro V, Von der Lippe E, Jakobsen LS, Devleesschauwer B, Plass D. Burden of disease attributable to risk factors in European countries: a scoping literature review. Arch Public Health 2023; 81:116. [PMID: 37355706 DOI: 10.1186/s13690-023-01119-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/24/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVES Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. METHODS We searched multiple literature databases, including grey literature websites and targeted public health agencies websites. RESULTS A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. CONCLUSIONS Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates. REGISTRATION The study protocol has been registered on PROSPERO, CRD42020177477 (available at: https://www.crd.york.ac.uk/PROSPERO/ ).
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Affiliation(s)
- Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Joana Nazaré Morgado
- Environmental Health and Nutrition Laboratory, University of Lisbon, Lisbon, Portugal
| | | | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | | | - João Vasco Santos
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal
- CINTESIS, Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACES Grande Porto V - Porto Ocidental, Porto, Portugal
| | - Jane Idavain
- Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia
| | - Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
| | - Isabel Noguer
- Carlos III Institute of Health, National School of Public Health, Madrid, Spain
| | | | - Rodrigo Sarmiento
- Carlos III Institute of Health, National School of Public Health, Madrid, Spain
- Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Vera Pinheiro
- CINTESIS, Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Elena Von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lea Sletting Jakobsen
- Division for Diet, Disease Prevention and Toxicology, Technical University of Denmark, Lyngby, Denmark
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Dietrich Plass
- Department for Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany
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Liu J, Hansen A, Varghese BM, Dear K, Tong M, Prescott V, Dolar V, Gourley M, Driscoll T, Zhang Y, Morgan G, Capon A, Bi P. Estimating the burden of disease attributable to high ambient temperature across climate zones: methodological framework with a case study. Int J Epidemiol 2023; 52:783-795. [PMID: 36511334 PMCID: PMC10244055 DOI: 10.1093/ije/dyac229] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 11/30/2022] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND With high temperature becoming an increasing health risk due to a changing climate, it is important to quantify the scale of the problem. However, estimating the burden of disease (BoD) attributable to high temperature can be challenging due to differences in risk patterns across geographical regions and data accessibility issues. METHODS We present a methodological framework that uses Köppen-Geiger climate zones to refine exposure levels and quantifies the difference between the burden observed due to high temperatures and what would have been observed if the population had been exposed to the theoretical minimum risk exposure distribution (TMRED). Our proposed method aligned with the Australian Burden of Disease Study and included two parts: (i) estimation of the population attributable fractions (PAF); and then (ii) estimation of the BoD attributable to high temperature. We use suicide and self-inflicted injuries in Australia as an example, with most frequent temperatures (MFTs) as the minimum risk exposure threshold (TMRED). RESULTS Our proposed framework to estimate the attributable BoD accounts for the importance of geographical variations of risk estimates between climate zones, and can be modified and adapted to other diseases and contexts that may be affected by high temperatures. CONCLUSIONS As the heat-related BoD may continue to increase in the future, this method is useful in estimating burdens across climate zones. This work may have important implications for preventive health measures, by enhancing the reproducibility and transparency of BoD research.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Alana Hansen
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Blesson M Varghese
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Keith Dear
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Michael Tong
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Vanessa Prescott
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Vergil Dolar
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Ying Zhang
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
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Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices. Epidemiol Infect 2023; 151:e19. [PMID: 36621004 PMCID: PMC9990389 DOI: 10.1017/s0950268823000031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.
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Rashidi R, Khaniabadi YO, Sicard P, De Marco A, Anbari K. Ambient PM 2.5 and O 3 pollution and health impacts in Iranian megacity. STOCHASTIC ENVIRONMENTAL RESEARCH AND RISK ASSESSMENT : RESEARCH JOURNAL 2023; 37:175-184. [PMID: 35965492 PMCID: PMC9358119 DOI: 10.1007/s00477-022-02286-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 05/21/2023]
Abstract
The main objectives of this study were to (i) assess variation within fine particles (PM2.5) and tropospheric ozone (O3) time series in Khorramabad (Iran) between 2019 (before) and 2020 (during COVID-19 pandemic); (ii) assess relationship between PM2.5 and O3, the PM2.5/O3 ratio, and energy consumption; and (iii) estimate the health effects of exposure to ambient PM2.5 and O3. From hourly PM2.5 and O3 concentrations, we applied both linear-log and integrated exposure-response functions, city-specific relative risk, and baseline incidence values to estimate the health effects over time. A significant correlation was found between PM2.5 and O3 (r =-0.46 in 2019, r =-0.55 in 2020, p < 0.05). The number of premature deaths for all non-accidental causes (27.5 and 24.6), ischemic heart disease (7.3 and 6.3), chronic obstructive pulmonary disease (17 and 19.2), and lung cancer (9.2 and 6.25) attributed to ambient PM2.5 exposure and for respiratory diseases (4.7 and 5.4) for exposure to O3 above 10 µg m-3 for people older than 30-year-old were obtained in 2019 and 2020. The number of years of life lost declined by 11.6% in 2020 and exposure to PM2.5 reduced the life expectancy by 0.58 and 0.45 years, respectively in 2019 and 2020. Compared to 2019, the restrictive measures associated to COVID-19 pandemic led to reduction in PM2.5 (-25.5%) and an increase of O3 concentration (+ 8.0%) in Khorramabad.
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Affiliation(s)
- Rajab Rashidi
- Department of Occupational Health, Nutritional Health Research Center, School of Health and Nutrition,
Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Yusef Omidi Khaniabadi
- Occupational and Environmental Health Research Center, Petroleum Industry Health Organization (PIHO), Ahvaz, Iran
| | | | | | - Khatereh Anbari
- Social Determinants of Health Research Center, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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Postma DJ, De Smet PAGM, Notenboom K, Leufkens HGM, Mantel-Teeuwisse AK. Impact of medicine shortages on patients - a framework and application in the Netherlands. BMC Health Serv Res 2022; 22:1366. [PMID: 36397073 PMCID: PMC9670055 DOI: 10.1186/s12913-022-08765-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Medicine shortages are often described in plain numbers, suggesting all shortages have a uniform impact. However, some shortages have a direct and serious effect on patients and need a prompt reaction from stakeholders. This study aims to create a broad framework to assess the impact of a shortage. Method We identified high impact shortages and selected exemplary shortages which we considered our learning cases. From five learning cases, we identified elements that had a potentially profound impact on one or more of these cases. We tested data saturation on the elements with another five test cases. Based on these elements, we created a framework to assess impact of shortages on patients and presented practical examples how to rate these different elements. Subsequently, we visualised the impact of these five learning cases on patients in radar charts. Results The five elements which we identified as potentially having a large impact were 1) alternative product, 2) disease, 3) susceptibility, 4) costs and 5) number of patients affected. The five learning cases rated high on different elements, leading to diverse and sometimes even opposite patterns of impact. Conclusion We created a framework for assessing the impact of a medicine shortage on patients by means of five key elements. By rating these elements, an indication of the impact can be obtained. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08765-x.
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Affiliation(s)
- Doerine J. Postma
- grid.5477.10000000120346234Division Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, PO Box 80 082, 3508 TB Utrecht, The Netherlands ,grid.489189.50000 0001 0708 7338Royal Dutch Pharmacists Association, The Hague, the Netherlands
| | - Peter A. G. M. De Smet
- grid.10417.330000 0004 0444 9382Departments of IQ healthcare and of clinical pharmacy, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Kim Notenboom
- grid.491235.80000 0004 0465 5952Dutch Medicines Evaluation Board, Utrecht, the Netherlands
| | - Hubert G. M. Leufkens
- grid.5477.10000000120346234Division Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, PO Box 80 082, 3508 TB Utrecht, The Netherlands
| | - Aukje K. Mantel-Teeuwisse
- grid.5477.10000000120346234Division Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, PO Box 80 082, 3508 TB Utrecht, The Netherlands
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Maimaitiming M, Wang M, Luo Y, Wang J, Jin Y, Zheng ZJ. Global trends and regional differences in the burden of cancer attributable to secondhand smoke in 204 countries and territories, 1990–2019. Front Oncol 2022; 12:972627. [PMID: 36303836 PMCID: PMC9592919 DOI: 10.3389/fonc.2022.972627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Background To describe the status quo and trends in the global burden of all cancers caused by secondhand smoke during 1990–2019. Methods Data on cancer associated with secondhand smoke were extracted from the Global Heath Data Exchange. Cancer burden was measured by cancer-related deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Results In 2019, age-standardized rates of death, DALYs and YLLs among the cancer population globally caused by secondhand smoke were 1.60, 38.54 and 37.77, respectively. The proportions of these in the total cancer burden for all risk factors combined decreased slightly from 1990 to 2003 and then increased from 2004 to 2019. In 2019, >50% of the cancer burden was concentrated in men aged 55–75 years and women aged 50–70 years. Between 1990 and 2019, there was an increase in age-standardized rates of death, DALYs, YLDs and YLLs among those aged ≥70 years. The age-standardized YLDs rate attributable to secondhand smoke was higher among women; it decreased in men but increased in women, causing a wider gap between the sexes. A greater cancer burden was mainly seen in North America in 1990 and Europe in 2019. Reductions in the annual rate change of cancer burden were found mainly in North America and Oceania, while increases were found in Africa and Asia. In 2019, high–middle- and middle-SDI countries had higher age-standardized rates of deaths, DALYs, YLDs and YLLs than the global level. During 1990 and 2019, the largest decline in cancer burden was seen in high-SDI countries, while middle- or low-SDI countries experienced increases in all age-standardized rates. Conclusions Cancer burden attributable to secondhand smoke is concerning given the increasing health loss and differences in distribution of cancer burden worldwide. Further studies are needed to investigate the causes of disparities in cancer burden attributable to secondhand smoke and to improve understanding of the contribution of secondhand smoke to the burden of different types of cancer.
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Affiliation(s)
- Mailikezhati Maimaitiming
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Minmin Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Jia Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute, Beijing, China
- *Correspondence: Yinzi Jin, ; Jia Wang,
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
- *Correspondence: Yinzi Jin, ; Jia Wang,
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
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Charalampous P, Gorasso V, Plass D, Pires SM, von der Lippe E, Mereke A, Idavain J, Kissimova-Skarbek K, Morgado JN, Ngwa CH, Noguer I, Padron-Monedero A, Santi-Cano MJ, Sarmiento R, Devleesschauwer B, Haagsma JA. Burden of non-communicable disease studies in Europe: a systematic review of data sources and methodological choices. Eur J Public Health 2022; 32:289-296. [PMID: 35015851 PMCID: PMC8975530 DOI: 10.1093/eurpub/ckab218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Assessment of disability-adjusted life years (DALYs) resulting from non-communicable diseases (NCDs) requires specific calculation methods and input data. The aims of this study were to (i) identify existing NCD burden of disease (BoD) activities in Europe; (ii) collate information on data sources for mortality and morbidity; and (iii) provide an overview of NCD-specific methods for calculating NCD DALYs. METHODS NCD BoD studies were systematically searched in international electronic literature databases and in grey literature. We included all BoD studies that used the DALY metric to quantify the health impact of one or more NCDs in countries belonging to the European Region. RESULTS A total of 163 BoD studies were retained: 96 (59%) were single-country or sub-national studies and 67 (41%) considered more than one country. Of the single-country studies, 29 (30%) consisted of secondary analyses using existing Global Burden of Disease (GBD) results. Mortality data were mainly derived (49%) from vital statistics. Morbidity data were frequently (40%) drawn from routine administrative and survey datasets, including disease registries and hospital discharge databases. The majority (60%) of national BoD studies reported mortality corrections. Multimorbidity adjustments were performed in 18% of national BoD studies. CONCLUSION The number of national NCD BoD assessments across Europe increased over time, driven by an increase in BoD studies that consisted of secondary data analysis of GBD study findings. Ambiguity in reporting the use of NCD-specific BoD methods underlines the need for reporting guidelines of BoD studies to enhance the transparency of NCD BoD estimates across Europe.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vanessa Gorasso
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Dietrich Plass
- Department for Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Alibek Mereke
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Jane Idavain
- National Institute for Health Development, Tallinn, Estonia
| | | | - Joana Nazaré Morgado
- Environmental Health and Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Isabel Noguer
- Carlos III Institute of Health, National School of Public Health, Madrid, Spain
| | | | - María José Santi-Cano
- Research Group on Nutrition: Molecular, pathophysiological and social issues, Biomedical Research and Innovation Institute of Cádiz (INiBICA), University of Cádiz, Cádiz, Spain
| | - Rodrigo Sarmiento
- Carlos III Institute of Health, National School of Public Health, Madrid, Spain
- Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Hao Z, Wang M, Zhu Q, Li J, Liu Z, Yuan L, Zhang Y, Zhang L. Association Between Socioeconomic Status and Prevalence of Cardio-Metabolic Risk Factors: A Cross-Sectional Study on Residents in North China. Front Cardiovasc Med 2022; 9:698895. [PMID: 35330947 PMCID: PMC8940519 DOI: 10.3389/fcvm.2022.698895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 02/09/2022] [Indexed: 11/20/2022] Open
Abstract
Studies have found associations between cardio-metabolic disorders and socioeconomic status (SES) in developed areas. However, little epidemiological data are available on residents of less developed areas in North China. A cross-sectional study that consisted of 2,650 adults randomly selected from local residents was conducted on a developing province, Hebei. SES was assessed in terms of education, personal income per year, and occupation. The association between SES and metabolic syndrome (MetS) was determined by multivariate logistic regression. The weighted prevalence of MetS was 26.8% among residents of Hebei province. The lower prevalence of MetS and abdominal obesity was associated with increase in SES groups. After adjustments regarding age, sex, body mass index, living area, smoking, salt intake, and family history of diabetes, odds ratio (OR) for elevated blood pressure (BP) of individuals with higher SES level was 0.71 [95% confidence interval (CI): 0.542–0.921] compared with those with lower SES level. Cardio-metabolic risk factors were commonly identified among residents of Hebei province in north China and were associated with SES conditions. This study indicated that from a public health perspective, more attention should be paid to screening of cardio-metabolic disorders in less developed areas.
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Santos JV, Gorasso V, Souza J, Wyper GMA, Grant I, Pinheiro V, Viana J, Ricciardi W, Haagsma JA, Devleesschauwer B, Plass D, Freitas A. Risk factors and their contribution to population health in the European Union (EU-28) countries in 2007 and 2017. Eur J Public Health 2021; 31:958-967. [PMID: 34468766 DOI: 10.1093/eurpub/ckab145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Global Burden of Disease (GBD) study has generated a wealth of data on death and disability outcomes in Europe. It is important to identify the disease burden that is attributable to risk factors and, therefore, amenable to interventions. This paper reports the burden attributable to risk factors, in deaths and disability-adjusted life years (DALYs), in the 28 European Union (EU) countries, comparing exposure to risks between them, from 2007 to 2017. METHODS Retrospective descriptive study, using secondary data from the GBD 2017 Results Tool. For the EU-28 and each country, attributable (all-cause) age-standardized death and DALY rates, and summary exposure values are reported. RESULTS In 2017, behavioural and metabolic risk factors showed a higher attributable burden compared with environmental risks, with tobacco, dietary risks and high systolic blood pressure standing out. While tobacco and air quality improved significantly between 2007 and 2017 in both exposure and attributable burden, others such as childhood maltreatment, drug use or alcohol use did not. Despite significant heterogeneity between EU countries, the EU-28 burden attributable to risk factors decreased in this period. CONCLUSION Accompanying the improvement of population health in the EU-28, a comparable trend is visible for attributable burden due to risk factors. Besides opportunities for mutual learning across countries with different disease/risk factors patterns, good practices (i.e. tobacco control in Sweden, air pollution mitigation in Finland) might be followed. On the opposite side, some concerning cases must be highlighted (i.e. tobacco in Bulgaria, Latvia and Estonia or drug use in Czech Republic).
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Affiliation(s)
- João Vasco Santos
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII, ARS Norte, Espinho/Gaia, Portugal
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Júlio Souza
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | | | | | - Vera Pinheiro
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal.,Public Health Unit, ULS Baixo Alentejo, ARS Alentejo, Beja, Portugal
| | - João Viana
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Walter Ricciardi
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli' IRCCS, Rome, Italy
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Dietrich Plass
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
| | - Alberto Freitas
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
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11
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Devleesschauwer B. European burden of disease network: strengthening the collaboration. Eur J Public Health 2021; 30:2-3. [PMID: 31978226 DOI: 10.1093/eurpub/ckz225] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
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12
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Lee DG, Lee MM, Jeong YM, Kim JG, Yoon YK, Shin WS. Influence of Forest Visitors' Perceived Restorativeness on Social-Psychological Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6328. [PMID: 34208025 PMCID: PMC8296131 DOI: 10.3390/ijerph18126328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 01/05/2023]
Abstract
This study was conducted to verify the perceived restorativeness of citizens visiting forests on social-psychological stress and psychological resilience according to forest space type. The study involved a questionnaire survey conducted on citizens who visited forests between 1 May and 15 July 2020, when social distancing in daily life was being implemented. Three types of forest spaces (urban forest, national park, and natural recreation forest) were selected for the survey. They used the survey results of 1196 people as analysis data for this study. In this study, the PRS (Perceived Restorativeness Scale) and the PWI-SF (Psychosocial Well-being Index Short Form) were used to evaluate perceived restorativeness and social-psychological stress of citizens visiting forests. In the study, the average score of visitors' perceived restorativeness was 5.31 ± 0.77. Social-psychological stress was found in the healthy group, potential stress group, and high-risk group. These groups made up 8.0%, 82.5%, and 9.5% of the respondents, respectively. Pearson's correlation analysis between perceived restorativeness and social-psychological stress revealed that the higher the perceived restorativeness, the lower the social-psychological stress. "Diversion Mood", "Not bored", and "Coherence", which are the sub-factors of perceived restorativeness according to the forest space type, were found to have meaningful results for psychological resilience. However, there was no significant difference in the forest space type between "Compatibility" and social-psychological stress, which are sub-factors of perceived restorativeness. In conclusion, the forest space type affects the psychological resilience of those who visit the forest. Urban forests, national parks, and natural recreation forests are places to reduce stress.
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Affiliation(s)
- Don-Gak Lee
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (D.-G.L.); (M.-M.L.); (Y.-M.J.)
| | - Mi-Mi Lee
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (D.-G.L.); (M.-M.L.); (Y.-M.J.)
| | - Young-Mi Jeong
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (D.-G.L.); (M.-M.L.); (Y.-M.J.)
| | - Jin-Gun Kim
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (D.-G.L.); (M.-M.L.); (Y.-M.J.)
| | - Yung-Kyoon Yoon
- Department of Forest Sciences, Chungbuk National University, Cheongju 28644, Korea;
| | - Won-Sop Shin
- Department of Forest Sciences, Chungbuk National University, Cheongju 28644, Korea;
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13
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Cuschieri S, Pallari E, Terzic N, Alkerwi A, Sigurvinsdottir R, Sigfusdottir ID, Devleesschauwer B. Conducting national burden of disease studies in small countries in Europe- a feasible challenge? ACTA ACUST UNITED AC 2021; 79:73. [PMID: 33971960 PMCID: PMC8112005 DOI: 10.1186/s13690-021-00599-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/03/2021] [Indexed: 11/23/2022]
Abstract
Background Burden of Disease (BoD) studies use disability-adjusted life years (DALYs) as a population health metric to quantify the years of life lost due to morbidity and premature mortality for diseases, injuries and risk factors occurring in a region or a country. Small countries usually face a number of challenges to conduct epidemiological studies, such as national BoD studies, due to the lack of specific expertise and resources or absence of adequate data. Considering Europe’s small countries of Cyprus, Iceland, Luxembourg, Malta and Montenegro, the aim was to assess whether the various national data sources identified are appropriate to perform national BoD studies. Main body The five small countries have a well-established mortality registers following the ICD10 classification, which makes calculation of years of life lost (YLL) feasible. A number of health information data sources were identified in each country, which can provide prevalence data for the calculation of years lived with disability (YLD) for various conditions. These sources include disease-specific registers, hospital discharge data, primary health care data and epidemiological studies, provided by different organisations such as health directorates, institutes of public health, statistical offices and other bodies. Hence, DALYs can be estimated at a national level through the combination of the YLL and YLD information. On the other hand, small countries face unique challenges such as difficulty to ensure sample representativeness, variations in prevalence estimates especially for rarer diseases, existence of a substantial proportion of non-residents affiliated to healthcare systems and potential exclusion from some European or international initiatives. Recently established BoD networks may provide a platform for small countries to share experiences, expertise, and engage with countries and institutions that have long-standing experience with BoD assessment. Conclusion Apart from mortality registries, adequate health data sources, notably for cancer, are potentially available at the small states to perform national BoD studies. Investing in sharing expert knowledge through engagement of researchers in BoD networks can enable the conduct of country specific BoD studies and the establishment of more accurate DALYs estimates. Such estimates can enable local policymakers to reflect on the relative burden of the different conditions that are contributing to morbidity and mortality at a country level.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Elena Pallari
- MRC Clinical Trials and Methodology Unit, University College London, 90 High Holborn, London, WC1V 6LJ, England
| | - Natasa Terzic
- Center for Health System Development, Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Ala'a Alkerwi
- Directorate of Health, Service Epidemiologiy and Statistics, Luxembourg, Luxembourg
| | | | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.,Teacher's College, Columbia University, New York, NY, USA
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
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14
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Gualano MR, Corradi A, Voglino G, Bert F, Siliquini R. Beyond COVID-19: a cross-sectional study in Italy exploring the covid collateral impacts on healthcare services. Health Policy 2021; 125:869-876. [PMID: 33840478 PMCID: PMC7987502 DOI: 10.1016/j.healthpol.2021.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/27/2021] [Accepted: 03/03/2021] [Indexed: 01/17/2023]
Abstract
With COVID-19, populations are facing unmet health needs due to fear of contagion, lockdown measures and overload of Healthcare services (HCS). The COCOS study aimed to investigate reduced healthcare access among Italian citizens, additionally looking for specific subgroups that will primarily need health services in the next future. A cross-sectional online survey was performed during the Italian lockdown between April and May 2020. Descriptive, univariable and multivariable (logistic regression models) analyses were performed: results are expressed as Odd Ratios and Adjusted Odd Ratios (ORs and AdjORs). Totally, 1,515 questionnaires were collected. Median age was 42 years (IQR 23), 65.6% were females. Around 21.8% declared to suffer from chronic diseases. About 32.4% faced a delay of a scheduled Medical Service (MS) by provider decision, 13.2% refused to access scheduled MS for the fear of contagion, and 6.5% avoided HCS even if having an acute onset issue. Alarmingly, 1.5% avoided Emergency Department when in need and 5.0% took medications without consulting any physician: patients suffering from chronic conditions resulted to be more prone to self-medication (AdjOR [95% CI]: 2.16 [1.16-4.02]). This study demonstrated that indirect effects of COVID-19 are significant. Large groups of population suffered delays and interruptions of medical services, and the most vulnerable were the most affected. Immediate efforts are needed to reduce the backlog that HCSs incurred in.
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Affiliation(s)
- Maria Rosaria Gualano
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy
| | - Alessio Corradi
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy
| | - Gianluca Voglino
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy.
| | - Fabrizio Bert
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy; AOU City of Health and Science of Turin, Turin, Italy
| | - Roberta Siliquini
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy; AOU City of Health and Science of Turin, Turin, Italy
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15
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von der Lippe E, Devleesschauwer B, Gourley M, Haagsma J, Hilderink H, Porst M, Wengler A, Wyper G, Grant I. Reflections on key methodological decisions in national burden of disease assessments. Arch Public Health 2020; 78:137. [PMID: 33384020 PMCID: PMC7774238 DOI: 10.1186/s13690-020-00519-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Summary measures of population health are increasingly used in different public health reporting systems for setting priorities for health care and social service delivery and planning. Disability-adjusted life years (DALYs) are one of the most commonly used health gap summary measures in the field of public health and have become the key metric for quantifying burden of disease (BoD). BoD methodology is, however, complex and highly data demanding, requiring a substantial capacity to apply, which has led to major disparities across researchers and nations in their resources to perform themselves BoD studies and interpret the soundness of available estimates produced by the Global Burden of Disease Study. METHODS BoD researchers from the COST Action European Burden of Disease network reflect on the most important methodological choices to be made when estimating DALYs. The paper provides an overview of eleven methodological decisions and challenges drawing on the experiences of countries working with BoD methodology in their own national studies. Each of these steps are briefly described and, where appropriate, some examples are provided from different BoD studies across the world. RESULTS In this review article we have identified some of the key methodological choices and challenges that are important to understand when calculating BoD metrics. We have provided examples from different BoD studies that have developed their own strategies in data usage and implementation of statistical methods in the production of BoD estimates. CONCLUSIONS With the increase in national BoD studies developing their own strategies in data usage and implementation of statistical methods in the production of BoD estimates, there is a pressing need for equitable capacity building on the one hand, and harmonization of methods on the other hand. In response to these issues, several BoD networks have emerged in the European region that bring together expertise across different domains and professional backgrounds. An intensive exchange in the experience of the researchers in the different countries will enable the understanding of the methods and the interpretation of the results from the local authorities who can effectively integrate the BoD estimates in public health policies, intervention and prevention programs.
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Affiliation(s)
- Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | | | - Michelle Gourley
- Indigenous Data Analysis and Reporting Unit, Australian Institute of Health and Welfare, Canberra, Australia
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henk Hilderink
- Centre for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Michael Porst
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Annelene Wengler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Grant Wyper
- Public Health Scotland, Edinburgh, Scotland, UK
| | - Ian Grant
- Public Health Scotland, Edinburgh, Scotland, UK
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16
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Forest and Wellbeing: Bridging Medical and Forest Research for Effective Forest-Based Initiatives. FORESTS 2020. [DOI: 10.3390/f11080791] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Research Highlights: This review gives an overview of existing literature on the emerging topic of human wellbeing-forest contact nexus and provides a preliminary framework linking forests to wellbeing by highlighting key variables affecting this relationship. Background and Objectives: Existing literature reveals the psychological, physiological and social wellbeing benefits of contact with forest ecosystems; however, the role of forests in this relationship remains largely unexplored. The objectives of this review are twofold: (i) to provide an overview of the contributions of forest experiences to human wellbeing and the related interplay with forest ecosystems and (ii) to identify knowledge gaps to inform future research and systematize information available for forest managers and planners to support the development of effective forest-based initiatives. Materials and Methods: A scoping review was performed with a five-phase method integrating a systematic approach on Scopus, Web of Science and PubMed databases and snowball search. Studies were analyzed using a descriptive-analytical method. Results: Overall, 93 papers were included in the review. These are mainly from health-related sciences providing limited information for forest managers, planners and practitioners. Four main underlying variables of the forest-wellbeing relationship are identified: interaction, forest features, sensorial dimension of the forest and individual traits and reactions. Conclusions: Forest-based initiatives provide good opportunities for supporting public health and time spent in contact with forests seems to have a “health-bonus”. Whether and to what extent forest management can contribute to this is still poorly investigated. There is the need to better study causal relationships between specific forest features, type of interactions, frequency and “dose” of experiences, individual reactions and needs and wellbeing effects to maximize benefits from forest-based initiatives.
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17
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Wyper GMA, Grant I, Fletcher E, McCartney G, Fischbacher C, Stockton DL. How do world and European standard populations impact burden of disease studies? A case study of disability-adjusted life years (DALYs) in Scotland. ACTA ACUST UNITED AC 2020; 78:1. [PMID: 31908777 PMCID: PMC6941317 DOI: 10.1186/s13690-019-0383-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/13/2019] [Indexed: 11/10/2022]
Abstract
Background Disability-Adjusted Life Years (DALYs) are an established method for quantifying population health needs and guiding prioritisation decisions. Global Burden of Disease (GBD) estimates aim to ensure comparability between countries and over time by using age-standardised rates (ASR) to account for differences in the age structure of different populations. Different standard populations are used for this purpose but it is not widely appreciated that the choice of standard may affect not only the resulting rates but also the rankings of causes of DALYs. We aimed to evaluate the impact of the choice of standard, using the example of Scotland. Methods DALY estimates were derived from the 2016 Scottish Burden of Disease (SBoD) study for an abridged list of 68 causes of disease/injury, representing a three-year annual average across 2014-16. Crude DALY rates were calculated using Scottish national population estimates. DALY ASRs standardised using the GBD World Standard Population (GBD WSP) were compared to those using the 2013 European Standard Population (ESP2013). Differences in ASR and in rank order within the cause list were summarised for all-cause and for each individual cause. Results The ranking of causes by DALYs were similar using crude rates or ASR (ESP2013). All-cause DALY rates using ASR (GBD WSP) were around 26% lower. Overall 58 out of 68 causes had a lower ASR using GBD WSP compared with ESP2013, with the largest falls occurring for leading causes of mortality observed in older ages. Gains in ASR were much smaller in absolute scale and largely affected causes that operated early in life. These differences were associated with a substantial change to the ranking of causes when GBD WSP was used compared with ESP2013. Conclusion Disease rankings based on DALY ASRs are strongly influenced by the choice of standard population. While GBD WSP offers international comparability, within-country analyses based on DALY ASRs should reflect local age structures. For European countries, including Scotland, ESP2013 may better guide local priority setting by avoiding large disparities occurring between crude and age-standardised results sets, which could potentially confuse non-technical audiences.
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Affiliation(s)
- Grant M A Wyper
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE Scotland
| | - Ian Grant
- 2Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland
| | - Eilidh Fletcher
- 2Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland
| | - Gerry McCartney
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE Scotland
| | - Colin Fischbacher
- 2Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland
| | - Diane L Stockton
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE Scotland
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18
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Santos JV, Souza J, Valente J, Alonso V, Ramalho A, Viana J, Ricciardi W, Freitas A. The state of health in the European Union (EU-28) in 2017: an analysis of the burden of diseases and injuries. Eur J Public Health 2019; 30:573-578. [DOI: 10.1093/eurpub/ckz203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The Global Burden of Disease study has generated a wealth of data on death and disability in Europe. At a time of change for the European Union and European Region of WHO, with a new Health Commissioner and Regional Director, respectively, a review of health trends can contribute to identify outstanding needs and gaps. This paper reports a summary of the burden of disease in the European Union (EU) in 2017 (compared with 2007).
Methods
For the whole EU and each country, mortality by causes of death, disability-adjusted life years (DALYs) and life expectancies are reported.
Results
In 2017, the age-standardized mortality and DALY rates were of 452.6 and 19 663.3 per 100 000 inhabitants, respectively. The diseases contributing most to mortality were ischaemic heart disease (IHD), dementias and stroke, while low back pain and IHD accounted for the highest burden of DALYs.
Conclusions
Overall, there was an improvement in the state of health in the EU but substantial differences between countries remain. Cardiovascular diseases still represent the major burden, although there have been substantial improvements. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease.
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Affiliation(s)
- João Vasco Santos
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS—Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACES Grande Porto VIII (ARS Norte), Espinho/Gaia, Portugal
| | - Júlio Souza
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS—Centre for Health Technology and Services Research, Porto, Portugal
| | - José Valente
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS—Centre for Health Technology and Services Research, Porto, Portugal
| | - Vera Alonso
- CINTESIS—Centre for Health Technology and Services Research, Porto, Portugal
| | - André Ramalho
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS—Centre for Health Technology and Services Research, Porto, Portugal
| | - João Viana
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS—Centre for Health Technology and Services Research, Porto, Portugal
| | - Walter Ricciardi
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico “A. Gemelli” IRCCS, Rome, Italy
| | - Alberto Freitas
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS—Centre for Health Technology and Services Research, Porto, Portugal
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19
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Wyper GMA, Grant I, Fletcher E, McCartney G, Stockton DL. The impact of worldwide, national and sub-national severity distributions in Burden of Disease studies: A case study of cancers in Scotland. PLoS One 2019; 14:e0221026. [PMID: 31398232 PMCID: PMC6688784 DOI: 10.1371/journal.pone.0221026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 07/30/2019] [Indexed: 12/12/2022] Open
Abstract
Background Increasingly Burden of Disease (BOD) measures are being used to influence policy decisions because they summarise the complete effects of morbidity and mortality in an equitable manner. An important element of producing non-fatal BOD estimates are severity distributions. The Global Burden of Disease (GBD) study use the same severity distributions across countries due to a lack of available country-specific data. In the Scottish BOD (SBOD) study we developed national severity distributions for cancer types. The main aim of this study was to consider the extent to which the use of worldwide severity distributions in BOD studies are influencing cross-country comparisons, by comparing weighted-average disability weights (DW) based on GBD severity distributions with nationally derived severity distributions in Scotland for cancer types. Methods We obtained individual records from the Scottish Cancer Registry for 21 cancer types and linked these to registered deaths. We estimated prevalent cancer cases for 2016 and assigned each case to sequelae using GBD 2016 study definitions. We compared the impact of using severity distributions based on GBD 2016, a Scotland-wide distribution, and distributions specific to deprivation strata in Scotland, on the weighted-average DW for each cancer type. Results The relative difference in point estimates of weighted-average DW based on GBD 2016 worldwide severity distributions compared with Scottish national severity distributions resulted in overestimates in the majority of cancers (17 out of 21 cancer types). The largest overestimates were for gallbladder and biliary tract cancer (70.8%), oesophageal cancer (31.6%) and pancreatic cancer (31.2%). Furthermore, the use of weighted-average DW based on Scottish national severity distributions rather than sub-national Scottish severity distributions stratified by deprivation quintile overestimated weighted-average DW in the least deprived areas (16 out of 18 cancer types), and underestimated in the most deprived areas (16 out of 18 cancer types). Conclusion Our findings illustrate a bias in point estimates of weighted-average DW created using worldwide severity distributions. This bias would have led to the misrepresentation of non-fatal estimates of the burden of individual cancers, and underestimated the scale of socioeconomic inequality in this non-fatal burden. This highlights the importance of not interpreting non-fatal estimates of burden of disease too precisely, especially for sub-national estimates and those comparing populations when relying on data inputs from other countries. It is essential to ensure that any estimates are based upon country-specific data as far as possible.
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Affiliation(s)
- Grant M. A. Wyper
- Public Health Science Directorate, NHS Health Scotland, Glasgow, Scotland
- * E-mail:
| | - Ian Grant
- Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
| | - Eilidh Fletcher
- Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
| | - Gerry McCartney
- Public Health Science Directorate, NHS Health Scotland, Glasgow, Scotland
| | - Diane L. Stockton
- Public Health Science Directorate, NHS Health Scotland, Glasgow, Scotland
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20
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O'Donovan MR, Sezgin D, Liew A, O'Caoimh R. Burden of disease, disability-adjusted life years and frailty prevalence. QJM 2019; 112:261-267. [PMID: 30541151 DOI: 10.1093/qjmed/hcy291] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/30/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Burden of disease (BoD) using disability-adjusted life years (DALY) is a useful summary measure of population health and estimates are provided for Ireland annually. We hypothesized that BoD may be used as a predictor of frailty prevalence. AIM To examine the correlation between frailty measured by the accumulation of deficits (frailty index, FI) and Fried frailty phenotype (FFP) classifications and BoD, in an Irish context. DESIGN Cross-sectional secondary analysis. METHODS Data were obtained from waves two and three of The Survey of Health, Ageing and Retirement in Europe for Irish adults aged ≥65 in 2007. Frailty was defined by a 70-item FI and the FFP. Years lived with disability (YLD), years of life lost (YLL) and DALY were calculated using adapted equations from the World Health Organization and, where possible, disability weights, sequelae and durations as in the Global BoD (GBD) project (2016). RESULTS Of 1035 participants, 442 were ≥65 years. Mean DALY were significantly higher in those identified as frail (FI: 3.31, P < 0.0001, n = 406; FFP: 2.46, P = 0.005, n = 319). For the FI, stronger correlation was found for DALY (r = 0.5431, P < 0.0001) than for age (r = 0.275, P < 0.0001). Controlling for confounders, DALY were an independent predictor of frailty when measured with the FI (OR 1.17, 95% CI: 1.10-1.24) but not with the FFP (OR 1.079, 95%% CI 1.00-1.17). CONCLUSIONS Frailty correlates significantly with DALY, and more so with the FI than the FFP, reaffirming that these measures are different constructs. GBD data could represent a predictor of population-level frailty estimates, facilitating improved comparisons.
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Affiliation(s)
- M R O'Donovan
- From the Clinical Sciences Institute, National University of Ireland, Galway (NUIG), Galway City, Ireland
| | - D Sezgin
- From the Clinical Sciences Institute, National University of Ireland, Galway (NUIG), Galway City, Ireland
| | - A Liew
- From the Clinical Sciences Institute, National University of Ireland, Galway (NUIG), Galway City, Ireland
- Portiuncula University Hospital, Galway, Ireland
| | - R O'Caoimh
- From the Clinical Sciences Institute, National University of Ireland, Galway (NUIG), Galway City, Ireland
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